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AGAPE CLINIC INC
NPI 1922720333
Family Medicine - Adult Medicine in Yuma, AZ

Active since September 13, 2022CLIA 03D2281298 · Waiver
2140 W 24TH ST STE B, YUMA, AZ 85364(928) 459-3400(928) 459-2077 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Agape Clinic Inc NPPES

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

AGAPE CLINIC INC (NPI 1922720333) is a healthcare organization registered as an adult medicine in Yuma, Arizona and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists John Ernest Williams, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1922720333
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameAGAPE CLINIC INC
Location Address2140 W 24TH ST STE BYuma, AZ 85364-8877
Mailing Address2140 W 24th St Ste BYuma, AZ 85364-8877 · (928) 503-4060 · Fax (928) 459-2077
Phone(928) 459-3400
Fax(928) 459-2077
Organization SubpartNo
Authorized OfficialJohn Ernest WilliamsExecutive Director · (928) 459-3400
Enumeration DateSeptember 13, 2022
NPPES CertifiedSeptember 13, 2022
✔ NPI 1922720333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
2140 W 24TH ST STE B, Yuma, AZ 85364
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Agape Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Agape Clinic Inc, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Danielle Miller, CRNP
Nurse Practitioner
NPI 1912171927
2140 W 24TH ST
Yuma, AZ 85364
(928) 459-3400
✔ PECOS✔ Accepts Medicare0.1 mi
Peter Dashkoff, M.D.
Internal Medicine
NPI 1912141367
2400 S AVENUE A
Yuma, AZ 85364
(928) 344-2000
✔ PECOS0.7 mi
Reina Ayala, MD
Family Practice
NPI 1407426976
1824 S 8TH AVE
Yuma, AZ 85364
(928) 343-2222
✔ PECOS✔ Accepts Medicare1.2 mi

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 of Waiver 03D2281298

Agape Clinic Inc · Yuma, AZ
Active · expires May 3, 2027
CLIA Number03D2281298
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorMario Vazquez
Laboratory Phone(928) 459-3400
Laboratory LocationAgape Clinic Inc2140 W 24th St Ste B, Yuma, AZ 85364
CLIA data matches this NPI record on: Address 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 Agape Clinic Inc's NPI number?

The NPI number for Agape Clinic Inc is 1922720333. It was assigned to this organization in the NPPES registry on September 13, 2022.

Where is Agape Clinic Inc located?

Agape Clinic Inc is located at 2140 W 24th St Ste B, Yuma, AZ 85364. The listed phone number is (928) 459-3400.

What is Agape Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Agape Clinic Inc enrolled in Medicare?

Yes. Agape Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Agape Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Agape Clinic Inc, in Family Practice, Internal Medicine and Nurse Practitioner. 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, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Agape Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2281298) is associated with this NPI, valid through May 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Agape Clinic Inc was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.