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PRIVIA MEDICAL GROUP ARIZONA, LLC
NPI 1740459700
Family Medicine in Payson, AZ

Active since February 25, 2008CLIA Certified · 3 labs
111 W CEDAR LN STE A, PAYSON, AZ 85541(602) 633-3780(602) 633-3782 Get Directions Write a Review

NPPES record last updated: May 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 22, 2024, Aug 5, 2024, Aug 24, 2023 (3 updates tracked since 2023).

About Privia Medical Group Arizona, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIVIA MEDICAL GROUP ARIZONA, LLC (NPI 1740459700) is a healthcare organization registered as a family medicine in Payson, Arizona and active in the NPI registry since February 2008. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Michael Mchorney, Cfo, as its authorized official.

NPPES Registry Identity

NPI1740459700
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIVIA MEDICAL GROUP ARIZONA, LLC
Location Address111 W CEDAR LN STE APayson, AZ 85541-5417
Mailing Address3815 E Bell Rd Ste 4500Phoenix, AZ 85032-2171 · (602) 633-3838 · Fax (602) 633-3850
Phone(602) 633-3780
Fax(602) 633-3782
Organization SubpartNo
Authorized OfficialMichael MchorneyCfo · (602) 633-3838
Enumeration DateFebruary 25, 2008
Last NPPES UpdateMay 2, 20253 updates tracked since enumeration
NPPES CertifiedMay 2, 2025
✔ NPI 1740459700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
111 W CEDAR LN STE A, Payson, AZ 85541
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1255 N Central Blvd, Ste 5Quartzsite, AZ 85346 · Phone (928) 927-6105
Location 22971 Willow Creek Rd, Bldg 3Prescott, AZ 86301 · Phone (928) 277-8088 · Fax (928) 460-5280

Other Identifiers 1

Medicaid326831AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Privia Medical Group Arizona, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

99

Medicare enrollment records show 99 clinicians reassign Medicare billing to Privia Medical Group Arizona, LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 16

Nurse Practitioner43
Family Practice17
Cardiovascular Disease (Cardiology)9
Internal Medicine8
Gastroenterology6
Interventional Cardiology4
Neurology2
Registered Dietitian or Nutrition Professional2
8 other specialties8

Nearest to this location (20)

See all 99
Morgan Gonzalez, FNP-C
Nurse Practitioner
NPI 1770274847
111 W CEDAR LN STE A
Payson, AZ 85541
(928) 475-4675
✔ PECOS✔ Accepts MedicareSame address
Amalia Pineres, MD
Family Practice
NPI 1750449419
111 W CEDAR LN STE A
Payson, AZ 85541
(928) 472-4675
✔ PECOS✔ Accepts MedicareSame address
James Vandruff, DO
Family Practice
NPI 1710481411
111 W CEDAR LN STE A
Payson, AZ 85541
(928) 472-4675
✔ PECOS✔ Accepts MedicareSame address
John Vandruff, MD
Family Practice
NPI 1700885563
111 W CEDAR LN SUITE A
Payson, AZ 85541
(928) 472-4675
✔ PECOS✔ Accepts MedicareSame address
Lory Baraz, M.D.
Endocrinology
NPI 1790780393
3815 E BELL RD STE 4100
Phoenix, AZ 85032
(602) 494-5040
✔ PECOS✔ Accepts Medicare56 mi
David Chadwick, D.O.
Family Practice
NPI 1164956041
3815 E BELL RD STE 2300
Phoenix, AZ 85032
(602) 942-3750
✔ PECOS✔ Accepts Medicare56 mi
Michael Drury, M.D.
Internal Medicine
NPI 1568462893
3815 E BELL RD SUITE 4100
Phoenix, AZ 85032
(602) 494-5040
✔ PECOS✔ Accepts Medicare56 mi
Bradford Gelzayd, M.D.
Gastroenterology
NPI 1306826086
3815 E BELL RD STE 3200
Phoenix, AZ 85032
(480) 840-1754
✔ PECOS✔ Accepts Medicare56 mi
Chelsea Greenwood, FNP
Nurse Practitioner
NPI 1740063890
3815 E BELL RD STE 4100
Phoenix, AZ 85032
(602) 494-5040
✔ PECOS✔ Accepts Medicare56 mi
Marie Mccormick, ANP
Nurse Practitioner
NPI 1376517631
3815 E BELL RD STE 3200
Phoenix, AZ 85032
(623) 433-0202
✔ PECOS✔ Accepts Medicare56 mi
Ian Newport, DPM
Podiatry
NPI 1891227294
3815 E BELL RD STE 3200
Phoenix, AZ 85032
(623) 882-1292
✔ PECOS✔ Accepts Medicare56 mi
Mauro Tucci, M.D.
Internal Medicine
NPI 1619156445
3815 E BELL RD STE 4100
Phoenix, AZ 85032
(602) 494-5040
✔ PECOS✔ Accepts Medicare56 mi
Weston Young, D.O.
Family Practice
NPI 1538456470
3815 E BELL RD STE 4100
Phoenix, AZ 85032
(602) 494-5040
✔ PECOS✔ Accepts Medicare56 mi
Islam Abujubara, MD
Neurology
NPI 1265626774
9250 N. 3RD SUITE 2007
Phoenix, AZ 85020
(623) 535-0050
✔ PECOS✔ Accepts Medicare62 mi
Michael Weng, M.D.
Orthopedic Surgery
NPI 1396837480
9250 N 3RD ST SUITE 3000
Phoenix, AZ 85020
(602) 633-3710
✔ PECOS✔ Accepts Medicare62 mi
Junaid Qureshi, M.D.
Nephrology
NPI 1235186628
4540 E BASELINE RD BLDG 6
Mesa, AZ 85206
(602) 633-6060
✔ PECOS✔ Accepts Medicare63 mi
Hiva Vakil, MD
Cardiovascular Disease (Cardiology)
NPI 1356480172
500 W THOMAS RD STE 460
Phoenix, AZ 85013
(623) 433-0202
✔ PECOS✔ Accepts Medicare67 mi
Tomas Rivera-Bonilla, MD
Interventional Cardiology
NPI 1881855294
340 E PALM LN STE A175
Phoenix, AZ 85004
(602) 386-1100
✔ PECOS✔ Accepts Medicare67 mi
Marc Eckhauser, M.D.
Vascular Surgery
NPI 1811997513
15571 N REEMS RD
Surprise, AZ 85374
(623) 544-6932
✔ PECOS✔ Accepts Medicare74 mi
Navtej Tung, M.D.
Anesthesiology
NPI 1992702203
14415 W MCDOWELL RD SUITE D102
Goodyear, AZ 85395
(623) 512-4190
✔ PECOS✔ Accepts Medicare80 mi
See all 99 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2147445

Privia Medical Group Arizona, LLC · Prescott, AZ
Active · expires Apr 18, 2028
CLIA Number03D2147445
Laboratory TypePhysician Office
Certificate Effective DateApril 19, 2026
Certificate Expiration DateApril 18, 2028
Laboratory DirectorJoshua Pittman
Laboratory Phone(928) 277-8088
Laboratory LocationPrivia Medical Group Arizona, LLC2971 Willow Creek Rd Bldg 3&4, Prescott, AZ 86301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D1075587

Privia Medical Group Arizona, LLC · Quartzsite, AZ
Active · expires Oct 22, 2027
CLIA Number03D1075587
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorRiyaz A. Sumar
Laboratory Phone(928) 937-6105
Laboratory LocationPrivia Medical Group Arizona, LLC255 N Central Blvd, Ste #5, Quartzsite, AZ 85346
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 03D1090623

Privia Medical Group Arizona, LLC · Phoenix, AZ
Active · expires May 31, 2028
CLIA Number03D1090623
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorMark A. Wasylenko
Laboratory Phone(602) 633-3838
Laboratory LocationPrivia Medical Group Arizona, LLC3815 E Bell Rd Ste 2300, Phoenix, AZ 85032
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Privia Medical Group Arizona, LLC's NPI number?

The NPI number for Privia Medical Group Arizona, LLC is 1740459700. It was assigned to this organization in the NPPES registry on February 25, 2008.

Where is Privia Medical Group Arizona, LLC located?

Privia Medical Group Arizona, LLC is located at 111 W Cedar Ln Ste A, Payson, AZ 85541. The listed phone number is (602) 633-3780.

What is Privia Medical Group Arizona, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Privia Medical Group Arizona, LLC enrolled in Medicare?

Yes. Privia Medical Group Arizona, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Privia Medical Group Arizona, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 99 clinicians in 16 Medicare specialties reassign their Medicare billing to Privia Medical Group Arizona, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (43), Family Practice (17) and Cardiovascular Disease (Cardiology) (9). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Privia Medical Group Arizona, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Privia Medical Group Arizona, LLC accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Privia Medical Group Arizona, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Privia Medical Group Arizona, LLC was last updated on May 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.