Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Centerwell Senior Primary Care Az Cs PC

Organization Family Medicine Physician · NPI 1043163348

Centerwell Senior Primary Care Az Cs PC is a Family Medicine Physician in Phoenix, Arizona. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12419 N Tatum Blvd # B114
Phoenix, AZ 85032-7708
Phone: (407) 447-7120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1043163348
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care Az Cs PC
Authorized official Angie Martinez — Senior Credentialing Professional · (407) 447-7120
Other names Centerwell Senior Primary Care-Paradise Valley
NPI enumeratedFebruary 17, 2026
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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