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BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
NPI 1841573870
Clinic/Center - Multi-Specialty in Phoenix, AZ

Active since September 26, 2011CLIA Certified · 7 labs
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012(602) 747-4000 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 17, 2026, Sep 19, 2024, Sep 13, 2024 and 1 more (4 updates tracked since 2021).

About Banner Physician Super Specialists Arizona Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC (NPI 1841573870) is a healthcare organization registered as a multi-specialty in Phoenix, Arizona and active in the NPI registry since September 2011. The organization holds 7 active CLIA laboratory certificates, maintains 40 additional practice locations, and lists Shiva Birdi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1841573870
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
Location Address2901 N CENTRAL AVE STE 160Phoenix, AZ 85012-2702
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(602) 747-4000
Organization SubpartYesParent: Banner Medical Group
Authorized OfficialShiva BirdiCeo · (602) 747-4000
Enumeration DateSeptember 26, 2011
Last NPPES UpdateApril 17, 20264 updates tracked since enumeration
NPPES CertifiedApril 17, 2026
✔ NPI 1841573870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
2901 N CENTRAL AVE STE 160, Phoenix, AZ 85012
Open in Google Maps ↗

Secondary Practice Locations 40

Location 15555 W Thunderbird RdGlendale, AZ 85306-4622 · Phone (602) 865-5561
Location 25601 W Eugie Ave Ste 100Glendale, AZ 85304-1256 · Phone (602) 865-4510
Location 35757 W Thunderbird Rd Ste E250Glendale, AZ 85306-5613 · Phone (602) 865-4470
Location 46644 E Baywood AveMesa, AZ 85206-1747 · Phone (480) 321-2000
Location 57575 E Earll DrScottsdale, AZ 85251-6915 · Phone (480) 448-7500
Location 69305 W Thomas Rd Ste 125Phoenix, AZ 85037-3359 · Phone (602) 865-4065
Location 79305 W Thomas Rd Ste 380Phoenix, AZ 85037-3368 · Phone (623) 327-4144
Location 81760 E Florence Blvd Ste 100Casa Grande, AZ 85122-4765 · Phone (520) 374-6505
Location 917900 N Porter RdMaricopa, AZ 85138-4228 · Phone (520) 233-2500
Location 101811 E McMurray BlvdCasa Grande, AZ 85122-5404 · Phone (520) 374-6530
Location 112050 W Southern AveApache Junction, AZ 85120-7305 · Phone (480) 733-3300
Location 1237000 N Gantzel RdQueen Creek, AZ 85140-7303 · Phone (480) 394-4000
Location 1337100 N Gantzel Rd Ste 214Queen Creek, AZ 85140-7353 · Phone (480) 733-7350
Location 141111 E McDowell RdPhoenix, AZ 85006-2612 · Phone (602) 839-2000
Location 151400 S Dobson RdMesa, AZ 85202-4707 · Phone (480) 412-3000
Location 161432 S Dobson Rd Ste 206Mesa, AZ 85202-4771 · Phone (480) 827-5540
Location 171432 S Dobson Rd Ste 209Mesa, AZ 85202-4771 · Phone (480) 412-6970
Location 181432 S Dobson Rd Ste 301Mesa, AZ 85202-4773 · Phone (480) 412-9400
Location 191432 S Dobson Rd Ste 304Mesa, AZ 85202-4773 · Phone (480) 412-7400
Location 201432 S Dobson Rd Ste 402Mesa, AZ 85202-4777 · Phone (480) 412-5550
Location 211432 S Dobson Rd Ste 403Mesa, AZ 85202-4777 · Phone (480) 412-7473
Location 221432 S Dobson Rd Ste 408Mesa, AZ 85202-4777 · Phone (480) 412-7486
Location 231432 S Dobson Rd Ste 506Mesa, AZ 85202-4778 · Phone (480) 412-6430
Location 241432 S Dobson Rd Ste 501Mesa, AZ 85202-4778 · Phone (480) 412-7474
Location 251432 S Dobson Rd Ste 509Mesa, AZ 85202-4778 · Phone (480) 412-6970
Location 261435 S Alma School RdChandler, AZ 85286-7144 · Phone (480) 668-1600
Location 271432 S Dobson Rd Ste 512Mesa, AZ 85202-4778 · Phone (480) 412-6336
Location 281450 S Dobson Rd Ste B221Mesa, AZ 85202-4745 · Phone (480) 827-5370
Location 29155 E Warner RdGilbert, AZ 85296-3082 · Phone (480) 649-6600
Location 301920 N Higley Rd Ste 308Gilbert, AZ 85234-1625 · Phone (480) 543-6600
Location 3120751 W Market StBuckeye, AZ 85396-7893 · Phone (623) 463-5000
Location 3221772 S Ellsworth Loop RdQueen Creek, AZ 85142-7709 · Phone (480) 512-3700
Location 334375 E Irma LnPhoenix, AZ 85050-4312 · Phone (480) 980-5800
Location 345310 W Thunderbird Rd Ste 110Glendale, AZ 85306-4709 · Phone (602) 865-4065
Location 355310 W Thunderbird Rd Ste 214Glendale, AZ 85306-4722 · Phone (602) 865-4480
Location 3614502 W Meeker BlvdSun City West, AZ 85375-5282 · Phone (623) 524-4000
Location 375310 W Thunderbird Rd Ste 301Glendale, AZ 85306-4710 · Phone (602) 865-4442
Location 385310 W Thunderbird Rd Ste 308Glendale, AZ 85306-4710 · Phone (602) 865-4442
Location 395310 W Thunderbird Rd Ste 310Glendale, AZ 85306-4710 · Phone (602) 865-4470
Location 405310 W Thunderbird Rd Ste 311Glendale, AZ 85306-4710 · Phone (602) 865-4230

Other Identifiers 1

Medicaid646532AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Oscar Health Plan, Inc..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)

Banner Physician Super Specialists Arizona Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

186

Medicare enrollment records show 186 clinicians reassign Medicare billing to Banner Physician Super Specialists Arizona LLC, which bills Medicare for the services they deliver. Of these, 41 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 31

Pediatric Medicine84
Nurse Practitioner21
General Surgery6
Hematology/Oncology6
Cardiovascular Disease (Cardiology)5
Clinical Psychologist4
Critical Care (Intensivists)4
Orthopedic Surgery4
23 other specialties52

Nearest to this location (20)

See all 186
Cortney Despain, FNP-C
Nurse Practitioner
NPI 1578209052
3141 N 3RD AVE STE 100
Phoenix, AZ 85013
(602) 914-1520
✔ PECOS0.4 mi
Jane Lyons, M.D.
Pediatric Medicine
NPI 1407117039
500 W THOMAS RD STE 250
Phoenix, AZ 85013
(602) 406-3520
✔ PECOS0.4 mi
Ramakant Sharma, MD
Critical Care (Intensivists)
NPI 1013137918
3330 N 2ND ST SUITE 300
Phoenix, AZ 85012
(602) 265-8965
✔ PECOS✔ Accepts Medicare0.4 mi
Shelly Batra, D.O.
Pediatric Medicine
NPI 1417183542
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Peter Chanin, M.D.
Pediatric Medicine
NPI 1497709141
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Danthuy Dao, D.O.
Emergency Medicine
NPI 1215942818
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Brad Fiorito, D.O.
Pediatric Medicine
NPI 1467415331
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Roberto Hayes, M.D.
Pediatric Medicine
NPI 1972557650
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Michael Young, M.D.
Pediatric Medicine
NPI 1356383483
350 W THOMAS RD
Phoenix, AZ 85013
(602) 406-3000
✔ PECOS0.4 mi
Kristen Yee, MD
Plastic and Reconstructive Surgery
NPI 1346225992
925 EAST MCDOWELL RD.
Phoenix, AZ 85006
(602) 521-3700
✔ PECOS✔ Accepts Medicare1.3 mi
Amal Isaiah, M.D., PH.D.
Otolaryngology
NPI 1558672709
1441 N 12TH ST FL 2
Phoenix, AZ 85006
(602) 839-2000
✔ PECOS1.5 mi
Kyung Chung, MD
Maxillofacial Surgery
NPI 1821208240
1441 N 12TH ST
Phoenix, AZ 85006
(602) 521-5150
✔ PECOS✔ Accepts Medicare1.6 mi
Sophie Loeb, MD
Pediatric Medicine
NPI 1215499504
4212 N 16TH ST
Phoenix, AZ 85016
(602) 263-1200
✔ PECOS1.8 mi
Tracy Butler, M.D.
Pediatric Medicine
NPI 1578556510
1919 E THOMAS RD
Phoenix, AZ 85016
(602) 933-1000
✔ PECOS1.8 mi
Sara York, M.D.
Hospitalist
NPI 1306290101
1919 E THOMAS RD
Phoenix, AZ 85016
(602) 546-2923
✔ PECOS1.8 mi
Shwetal Lalan, MD
Nephrology
NPI 1912210907
1920 E CAMBRIDGE AVE STE 200
Phoenix, AZ 85006
(602) 933-0965
✔ PECOS1.9 mi
Urszula Kotlow, M.D.
Psychiatry
NPI 1871692178
1919 E THOMAS RD AMBULATORY BUILDING
Phoenix, AZ 85016
(602) 546-0990
✔ PECOS1.9 mi
Masayo Watanabe, M.D.
Hematology/Oncology
NPI 1699734434
1919 E THOMAS RD
Phoenix, AZ 85016
(602) 933-0920
✔ PECOS1.9 mi
Eileen Conway, PSY.D.
Clinical Psychologist
NPI 1912287863
522 N CENTRAL AVE # 1821
Phoenix, AZ 85004
(623) 252-1224
✔ PECOS2.6 mi
Amanda Hawkins, RD
Registered Dietitian or Nutrition Professional
NPI 1841943453
2601 E ROOSEVELT ST
Phoenix, AZ 85008
(602) 344-4216
3.2 mi
See all 186 clinicians

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 7

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 03D2111356

Banner Physician Super Specialists Arizona LLC · Glendale, AZ
Active · expires Apr 4, 2028
CLIA Number03D2111356
Laboratory TypePhysician Office
Certificate Effective DateApril 5, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorEdward Carter
Laboratory Phone(602) 865-4470
Laboratory LocationBanner Physician Super Specialists Arizona LLC5310 W Thunderbird Rd Ste 310, Glendale, AZ 85306
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 03D1071752

Banner Physician Super Specialists Arizona LLC · Glendale, AZ
Active · expires Jan 10, 2028
CLIA Number03D1071752
Laboratory TypePhysician Office
Certificate Effective DateJanuary 11, 2026
Certificate Expiration DateJanuary 10, 2028
Laboratory DirectorViren Bavishi
Laboratory Phone(602) 865-4442
Laboratory LocationBanner Physician Super Specialists Arizona LLC5310 W Thunderbird Rd, Suite 301, Glendale, AZ 85306
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 03D2238115

Banner Physician Super Specialists Arizona LLC · Mesa, AZ
Active · expires Sep 29, 2027
CLIA Number03D2238115
Laboratory TypePhysician Office
Certificate Effective DateSeptember 30, 2025
Certificate Expiration DateSeptember 29, 2027
Laboratory DirectorLeno M. Thomas
Laboratory Phone(480) 412-6430
Laboratory LocationBanner Physician Super Specialists Arizona LLC1432 S Dobson Rd Ste 506, Mesa, AZ 85202
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 03D2024756

Banner Physician Super Specialists Arizona LLC · Glendale, AZ
Active · expires May 22, 2027
CLIA Number03D2024756
Laboratory TypeMedical Clinic Office
Certificate Effective DateMay 23, 2025
Certificate Expiration DateMay 22, 2027
Laboratory DirectorSwati Kolpuru
Laboratory Phone(602) 865-4230
Laboratory LocationBanner Physician Super Specialists Arizona LLC5310 W Thunderbird Rd Ste 311, Glendale, AZ 85306
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 03D2217366

Banner Physician Super Specialists Arizona LLC · Queen Creek, AZ
Active · expires Mar 18, 2027
CLIA Number03D2217366
Laboratory TypePhysician Office
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorMichael Young
Laboratory Phone(480) 733-7350
Laboratory LocationBanner Physician Super Specialists Arizona LLC37100 N Gantzel Rd Ste 214, Queen Creek, AZ 85140
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 03D2019766

Banner Physician Super Specialists Arizona LLC · Mesa, AZ
Active · expires Feb 3, 2027
CLIA Number03D2019766
Laboratory TypeMedical Clinic
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorDavid Valenzuela
Laboratory Phone(480) 412-7474
Laboratory LocationBanner Physician Super Specialists Arizona LLC1432 S Dobson Ste 501, Mesa, AZ 85202
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Banner Physician Super Specialists Arizona LLC's NPI number?

The NPI number for Banner Physician Super Specialists Arizona LLC is 1841573870. It was assigned to this organization in the NPPES registry on September 26, 2011.

Where is Banner Physician Super Specialists Arizona LLC located?

Banner Physician Super Specialists Arizona LLC is located at 2901 N Central Ave Ste 160, Phoenix, AZ 85012. The listed phone number is (602) 747-4000.

What is Banner Physician Super Specialists Arizona LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Banner Physician Super Specialists Arizona LLC enrolled in Medicare?

Yes. Banner Physician Super Specialists Arizona LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Banner Physician Super Specialists Arizona LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 186 clinicians in 31 Medicare specialties reassign their Medicare billing to Banner Physician Super Specialists Arizona 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. The largest specialties are Pediatric Medicine (84), Nurse Practitioner (21) and General Surgery (6). Of these, 41 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Banner Physician Super Specialists Arizona LLC hold CLIA laboratory certificates?

Yes. 7 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 Banner Physician Super Specialists Arizona LLC accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health and Oscar Health Plan, Inc. list Banner Physician Super Specialists 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 Banner Physician Super Specialists Arizona LLC was last updated on April 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.