Centerwell Senior Primary Care Az PC
NPI 1205583549ActiveOrganization· Internal Medicine· Glendale, AZ
Internal Medicine in Glendale, Arizona, registered in NPPES in March 2022, part of Centerwell Senior Primary Care Az PC. The authorized official on file is Angie Martinez, Senior Credentialing Professional.
Overview
| NPI | 1205583549 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Centerwell Senior Primary Care Az PC |
| NPI issued | Mar 7, 2022 |
| Last updated in NPPES | Aug 19, 2024 |
| Certified by provider | Aug 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| General Practice | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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