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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: July 26, 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
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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.Insurance ›

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.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES EDWARD VANDRUFF DO
Family Medicine
111 W CEDAR LN STE A
PAYSON, AZ 85541
Gila County (928) 472-4675
AMALIA D PINERES MD
Family Medicine
111 W CEDAR LN STE A
PAYSON, AZ 85541
Gila County (928) 472-4675
MORGAN GONZALEZ FNP-C
Nurse Practitioner (Family)
111 W CEDAR LN STE A
PAYSON, AZ 85541
Gila County (928) 475-4675
MONA YOUSSEF M.D.
Internal Medicine (Interventional Cardiology)
111 W CEDAR LN STE A
PAYSON, AZ 85541
Gila County (623) 433-0202
MARY ELLEN MCINTIRE M.D.
Family Medicine
111 W CEDAR LN STE A
PAYSON, AZ 85541
Gila County (928) 472-4675

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.

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 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 15 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.