CANYON FAMILY MEDICINE PLLC
NPI 1780349902
Family Medicine in Mesa, AZ
About Canyon Family Medicine Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CANYON FAMILY MEDICINE PLLC (NPI 1780349902), doing business as Canyon Family Medicine, is a healthcare organization registered as a family medicine in Mesa, Arizona and active in the NPI registry since November 2021. The organization holds a CLIA Microscopy certificate valid through January 12, 2028 and lists Laura Ayn Hafez, Founder, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted 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)
Canyon Family Medicine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Canyon Family Medicine PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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
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 for Provider-Performed Microscopy Procedures (PPMP) 03D2248530
Canyon Family Medicine · Mesa, AZFrequently 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 Canyon Family Medicine PLLC's NPI number?
The NPI number for Canyon Family Medicine PLLC is 1780349902. It was assigned to this organization in the NPPES registry on November 2, 2021. The provider is doing business as Canyon Family Medicine.
Where is Canyon Family Medicine PLLC located?
Canyon Family Medicine PLLC is located at 6242 E Arbor Ave Ste 118, Mesa, AZ 85206. The listed phone number is (602) 805-4914.
What is Canyon Family Medicine PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Canyon Family Medicine PLLC enrolled in Medicare?
Yes. Canyon Family Medicine PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Canyon Family Medicine PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Canyon Family Medicine PLLC. 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. Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Canyon Family Medicine PLLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D2248530) is associated with this NPI, valid through January 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Canyon Family Medicine PLLC accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Canyon Family Medicine PLLC 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 Canyon Family Medicine PLLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Canyon Family Medicine Pllc · NPI 1780349902
Family Medicine organization in Mesa, Arizona. Organization record, active in the CMS NPPES registry since November 2, 2021.
## Identity
- **NPI:** 1780349902 (Entity type: Organization)
- **Enumerated:** November 2, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Canyon Family Medicine (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Laura Hafez, FOUNDER
## Practice location
- **Address:** 6242 E ARBOR AVE STE 118, Mesa, AZ 85206-1309
- **Phone:** (602) 805-4914 · **Fax:** (602) 805-4917
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2025
- **Other identifiers:** Medicaid 104341 (AZ)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1780349902) · Data from the CMS NPPES public registry.