EAST VALLEY PRIMARY CARE, LLC
NPI 1811280530
Family Medicine in Mesa, AZ
About East Valley Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST VALLEY PRIMARY CARE, LLC (NPI 1811280530) is a healthcare organization registered as a family medicine in Mesa, Arizona and active in the NPI registry since May 2011. The organization lists Stacia B Kagie, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
East Valley Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to East Valley Primary Care, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 East Valley Primary Care, LLC's NPI number?
The NPI number for East Valley Primary Care, LLC is 1811280530. It was assigned to this organization in the NPPES registry on May 27, 2011.
Where is East Valley Primary Care, LLC located?
East Valley Primary Care, LLC is located at 3035 S Ellsworth Rd Ste 103, Mesa, AZ 85212. The listed phone number is (480) 736-1777.
What is East Valley Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is East Valley Primary Care, LLC enrolled in Medicare?
Yes. East Valley Primary Care, LLC is registered in the Medicare PECOS enrollment system.
When is East Valley Primary Care, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arizona, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through East Valley Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to East Valley Primary Care, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for East Valley Primary Care, LLC was last updated on May 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# East Valley Primary Care, Llc · NPI 1811280530
Family Medicine organization in Mesa, Arizona. Organization record, active in the CMS NPPES registry since May 27, 2011.
## Identity
- **NPI:** 1811280530 (Entity type: Organization)
- **Enumerated:** May 27, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Stacia Kagie, PHYSICIAN
## Practice location
- **Address:** 3035 S ELLSWORTH RD STE 103, Mesa, AZ 85212-2136
- **Phone:** (480) 736-1777 · **Fax:** (480) 736-1144
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 27, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1811280530) · Data from the CMS NPPES public registry.