SCOTTSDALE INTERNAL MEDICINE PLLC
NPI 1790050409
Clinical Nurse Specialist - Adult Health in Phoenix, AZ
About Scottsdale Internal Medicine Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SCOTTSDALE INTERNAL MEDICINE PLLC (NPI 1790050409) is a healthcare organization registered as an adult health in Phoenix, Arizona and active in the NPI registry since March 2012. The organization maintains a secondary practice location in Scottsdale and lists Charles Benjamin Evans, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Scottsdale Internal Medicine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Scottsdale Internal Medicine PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Scottsdale Internal Medicine PLLC's NPI number?
The NPI number for Scottsdale Internal Medicine PLLC is 1790050409. It was assigned to this organization in the NPPES registry on March 13, 2012.
Where is Scottsdale Internal Medicine PLLC located?
Scottsdale Internal Medicine PLLC is located at 4643 N 12th St Ste 101, Phoenix, AZ 85014. The listed phone number is (602) 812-3789.
What is Scottsdale Internal Medicine PLLC's specialty?
The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Adult Health, with taxonomy code 364SA2200X.
Is Scottsdale Internal Medicine PLLC enrolled in Medicare?
Yes. Scottsdale Internal Medicine PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Scottsdale Internal Medicine PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Scottsdale Internal 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. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Scottsdale Internal Medicine PLLC was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Scottsdale Internal Medicine Pllc · NPI 1790050409
Adult Health organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since March 13, 2012.
## Identity
- **NPI:** 1790050409 (Entity type: Organization)
- **Enumerated:** March 13, 2012
- **Primary specialty:** Clinical Nurse Specialist - Adult Health · taxonomy 364SA2200X
- **Organization subpart:** No
- **Authorized official:** Charles Evans, OWNER
## Practice location
- **Address:** 4643 N 12TH ST STE 101, Phoenix, AZ 85014-4083
- **Phone:** (602) 812-3789
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Internal Medicine (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1790050409) · Data from the CMS NPPES public registry.