EVOLUTION HEALTHCARE MANAGEMENT LLC
NPI 1770951980
Clinic/Center - Primary Care in Mesa, AZ

NPI Status: Active since September 03, 2015

Contact Information

7615 E BASELINE RD
SUITE 101
MESA, AZ
ZIP 85209
Phone: (480) 354-7878

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  • Organization
  • Clinic/Center
  • Primary Care
  • Accepts Insurance
  • CLIA Number: 03D2179363
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-20-2028

About EVOLUTION HEALTHCARE MANAGEMENT LLC

This page provides the complete NPI Profile along with additional information for Evolution Healthcare Management Llc, a primary care provider established in Mesa, Arizona operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1770951980 assigned on September 2015. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Fawn Michelle Boonstra (President, Manager)

NPI
1770951980
Provider Legal Name
EVOLUTION HEALTHCARE MANAGEMENT LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
7615 E BASELINE RD SUITE 101 MESA, AZ 85209
Location Phone
(480) 354-7878
Mailing Address
99 S GOLD DR STE 6 APACHE JUNCTION, AZ 85120
Mailing Phone
(480) 354-7878
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-03-2015
Last Update Date
09-12-2025
Code Navigator

A primary care provider (PCP) like Evolution Healthcare Management Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 99 S Gold Dr Ste. 6
    Apache Junction, AZ 85120
    (620) 694-3190

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities
License State
AZ

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

FAWN MICHELLE BOONSTRA

Authorized Official Title
PRESIDENT, MANAGER
Authorized Official Phone
(480) 286-7907

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D2179363
Facility Type
Physician Office
Certificate Effective Date
February 21, 2026
Certificate Expiration Date
February 20, 2028
Laboratory Director
SHINY S. THOMAS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Evolution Healthcare Management Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1770951980, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 1 → 2 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 1 + 8 + 5 + 2 + 9 + 1 + 6 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1770951980.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (Urgent Care)
7615 E BASELINE RD
MESA, AZ 85209

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770951980, enumerated as an "organization" on September 03, 2015.

The provider is located at 7615 E BASELINE RD SUITE 101 MESA, AZ 85209 and the phone number is (480) 354-7878.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health. Please consult your insurance carrier or call the provider to verify.