Banner - University Super Specialists LLC - Medicare Primary Care in Phoenix, AZ

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Banner - University Super Specialists LLC is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Phoenix, Arizona. The current practice location for Banner - University Super Specialists LLC is 2901 N Central Ave Ste 160, Phoenix, Arizona. For appointments, you can reach them via phone at (602) 747-4000. The mailing address for Banner - University Super Specialists LLC is 2901 N Central Ave Ste 160, Phoenix, Arizona.

Banner - University Super Specialists LLC is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1740650555. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (602) 747-4000.

Contact Information

Banner - University Super Specialists LLC
2901 N Central Ave Ste 160
Phoenix
AZ 85012-2702
(602) 747-4000
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameBanner - University Super Specialists LLC
SpecialityClinic/Center
Location2901 N Central Ave Ste 160, Phoenix, Arizona
Authorized Official Name and PositionBenjamin Schwartz (PRESIDENT)
Authorized Official Contact6027474000
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Banner - University Super Specialists LLC
2901 N Central Ave Ste 160
Phoenix
AZ 85012-2702
Banner - University Super Specialists LLC
2901 N Central Ave Ste 160
Phoenix
AZ 85012-2702

Ph: (602) 747-4000

NPI Details:

NPI Number1740650555
Provider Enumeration Date10/06/2015
Last Update Date04/17/2026
Certification Date04/17/2026

Medicare PECOS Information:

Medicare PECOS PAC ID1850695255
Medicare Enrollment IDO20160204002443

Medical Identifiers

Medical identifiers for Banner - University Super Specialists LLC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1740650555NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty ()Primary
261QX0200XClinic/center - Oncology ()Secondary
282N00000XGeneral Acute Care Hospital ()Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Banner - University Super Specialists LLC acts as a billing entity for following providers:
Provider NameValentin Zaharia
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1467455089
PECOS PAC ID: 3678476157
Enrollment ID: I20040130000985
Provider NameShouwen Wang
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1700889326
PECOS PAC ID: 9638167406
Enrollment ID: I20040503000516
Provider NameEdgardo R Laurel
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1992708788
PECOS PAC ID: 9830160878
Enrollment ID: I20040804000101
Provider NameMark N Wong
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1821054081
PECOS PAC ID: 9436121316
Enrollment ID: I20040811000294
Provider NameMaher M Mousa
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1184622243
PECOS PAC ID: 5597738781
Enrollment ID: I20040816001388
Provider NameRichard Sue
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1053320168
PECOS PAC ID: 5991772063
Enrollment ID: I20040916000999
Provider NameAmandeep S Khurana
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1508852716
PECOS PAC ID: 5294765509
Enrollment ID: I20050816001215
Provider NameHassan a Hachem
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1598768020
PECOS PAC ID: 1456301498
Enrollment ID: I20051021000645
Provider NameSanjay Lamba
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1619060449
PECOS PAC ID: 6204891708
Enrollment ID: I20060314000054
Provider NameAlejandro Morales
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1134192909
PECOS PAC ID: 1759353592
Enrollment ID: I20060316000121
Provider NameRomanita D Nica
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1366486144
PECOS PAC ID: 9335159151
Enrollment ID: I20060425000039
Provider NameHarvey Hsu
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1659330769
PECOS PAC ID: 4486665569
Enrollment ID: I20060606000261
Provider NameJamal Atalla
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1609861566
PECOS PAC ID: 5890760391
Enrollment ID: I20060712000016
Provider NameKatharine Dahl
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1073559621
PECOS PAC ID: 6901809995
Enrollment ID: I20060811000218
Provider NameArvind Durvasan
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1417038548
PECOS PAC ID: 9436157559
Enrollment ID: I20061127000244
Provider NameKaya M Macmillan
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1578511168
PECOS PAC ID: 5193726578
Enrollment ID: I20070127000104
Provider NameAlberto X Ramos
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1487788998
PECOS PAC ID: 0446341408
Enrollment ID: I20070806000068
Provider NameMegan Dixon
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1689868416
PECOS PAC ID: 2264506146
Enrollment ID: I20080812000030
Provider NameIbrahim Qaqish
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1740462431
PECOS PAC ID: 7012084023
Enrollment ID: I20080917000198
Provider NameLuz O Pelayo-katsanis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306094008
PECOS PAC ID: 2466520440
Enrollment ID: I20081003000342
Provider NameKenneth S Knox
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1154386118
PECOS PAC ID: 4981761137
Enrollment ID: I20090316000414
Provider NameErin K Ferguson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649437617
PECOS PAC ID: 6002962495
Enrollment ID: I20091016000227
Provider NameStephen M Schinker
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1134304173
PECOS PAC ID: 9032285507
Enrollment ID: I20100712000305
Provider NameLucille K Mcelrath
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801114269
PECOS PAC ID: 6305025578
Enrollment ID: I20110120000932
Provider NameVidette Villareal-argente
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033413125
PECOS PAC ID: 2062693195
Enrollment ID: I20110223000380
Provider NameScott Andrew Ungar
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1306075924
PECOS PAC ID: 0143499228
Enrollment ID: I20110805000409
Provider NameBasel Channis
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1982834594
PECOS PAC ID: 0345490736
Enrollment ID: I20121019000513
Provider NameShoma Bommena
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1952610966
PECOS PAC ID: 4183866270
Enrollment ID: I20130820001009
Provider NameLauren Sapp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982955415
PECOS PAC ID: 9032346523
Enrollment ID: I20131206001470
Provider NameManjunath Shivamanya Kottalgi
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1497082432
PECOS PAC ID: 6608099254
Enrollment ID: I20140529000150
Provider NameGerard C Quigley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881030781
PECOS PAC ID: 3870721129
Enrollment ID: I20140625002104
Provider NameJorida Lulaj
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679973911
PECOS PAC ID: 5698993871
Enrollment ID: I20140829001804
Provider NameRachel L Armenta
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801287354
PECOS PAC ID: 1254658867
Enrollment ID: I20150319001015
Provider NameShefali Gupta
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1902927981
PECOS PAC ID: 0143315556
Enrollment ID: I20150623002931
Provider NameRamachandra R Sista
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1083740252
PECOS PAC ID: 8628095551
Enrollment ID: I20150701001476
Provider NameJana M Montez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770950438
PECOS PAC ID: 4688982960
Enrollment ID: I20151006002784
Provider NameBrittany Cleveland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578947891
PECOS PAC ID: 8820391899
Enrollment ID: I20160125002832
Provider NameDavid Y Moromisato
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1386771707
PECOS PAC ID: 0042346322
Enrollment ID: I20160209002592
Provider NameMinesh Rajpal
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1568760502
PECOS PAC ID: 7315231503
Enrollment ID: I20160810002863
Provider NameMichael B Fallon
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1629163613
PECOS PAC ID: 0446313662
Enrollment ID: I20161025002568
Provider NameSantosh S Hanmod
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1730337478
PECOS PAC ID: 9335462811
Enrollment ID: I20161128001905
Provider NameNaresh Reddivalla
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1073851150
PECOS PAC ID: 8628367711
Enrollment ID: I20170718001431
Provider NameTessa M Janovsky
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1538680079
PECOS PAC ID: 1456622794
Enrollment ID: I20170804003154
Provider NameMichelina C De La Maza
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1255779385
PECOS PAC ID: 7012280852
Enrollment ID: I20170830001672
Provider NameHeather Ann Fett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811423262
PECOS PAC ID: 5193099802
Enrollment ID: I20170919003316
Provider NameJen Jung Pan
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1811073166
PECOS PAC ID: 0345386587
Enrollment ID: I20171003006326
Provider NameDina M Gibson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063998912
PECOS PAC ID: 1557611902
Enrollment ID: I20180905001679
Provider NameHolly Elizabeth Pariury
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1508129156
PECOS PAC ID: 4587915863
Enrollment ID: I20180926000143
Provider NameAravind Sugumar
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1124222716
PECOS PAC ID: 1153408075
Enrollment ID: I20190109000915
Provider NamePablo Andres Angulo
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1902122120
PECOS PAC ID: 1658660790
Enrollment ID: I20190222002572
Provider NameScott Tomlinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326512203
PECOS PAC ID: 6305186479
Enrollment ID: I20190327002829
Provider NameBrandon Gardner
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1770979627
PECOS PAC ID: 9335482595
Enrollment ID: I20190510001478
Provider NameMonica Margaret Davini
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1952643348
PECOS PAC ID: 8123355237
Enrollment ID: I20190813001269
Provider NameMisty Villar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831742618
PECOS PAC ID: 2961731526
Enrollment ID: I20190906000756
Provider NameSuman S Misra
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1023470879
PECOS PAC ID: 6709116775
Enrollment ID: I20190918002350
Provider NameJoseph Torkildson
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1710944095
PECOS PAC ID: 7911959499
Enrollment ID: I20190919000152
Provider NameRohit Nathan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1528321437
PECOS PAC ID: 6709192347
Enrollment ID: I20190923001303
Provider NameKelly Lynae Richardson
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1760618730
PECOS PAC ID: 7214299627
Enrollment ID: I20191216000964
Provider NameEmmanuel Katsanis
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1720053291
PECOS PAC ID: 2264539121
Enrollment ID: I20191231000481
Provider NameLaurel Christine Truscott
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1730421579
PECOS PAC ID: 7911271267
Enrollment ID: I20200323001179
Provider NameKarla M Baning
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972892032
PECOS PAC ID: 5597054973
Enrollment ID: I20200414000670
Provider NameMy Thuong Thi Quirino
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1245859115
PECOS PAC ID: 8527479138
Enrollment ID: I20201202001563
Provider NameWinnie Stuempfle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407448046
PECOS PAC ID: 1456767623
Enrollment ID: I20210312001504
Provider NameKaler Douglas Ray
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1346839495
PECOS PAC ID: 2264841303
Enrollment ID: I20210503000567
Provider NameRajan None Kapoor
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1376881177
PECOS PAC ID: 3971727488
Enrollment ID: I20210518000607
Provider NameSamer Bani Hani
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1700086550
PECOS PAC ID: 3072757020
Enrollment ID: I20210527001513
Provider NameSaed Sulaiman Mohd Nemr
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1992892772
PECOS PAC ID: 4385799097
Enrollment ID: I20210716000333
Provider NameKevin Liu
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1831517671
PECOS PAC ID: 0941560171
Enrollment ID: I20210825003069
Provider NameMa Ai Thanda Han
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1114202579
PECOS PAC ID: 4284967852
Enrollment ID: I20210915000944
Provider NameMoises Nevah Rubin
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1841482429
PECOS PAC ID: 7113011552
Enrollment ID: I20211006001370
Provider NameKatrina Zwack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942870472
PECOS PAC ID: 3476942798
Enrollment ID: I20211108001284
Provider NameKenneth Bodziak
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1699790295
PECOS PAC ID: 2961392246
Enrollment ID: I20211129001467
Provider NameRachel Voyles
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1407514276
PECOS PAC ID: 3577958230
Enrollment ID: I20220315002089
Provider NameKarn Wijarnpreecha
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942683008
PECOS PAC ID: 9335449495
Enrollment ID: I20220329002556
Provider NameLeandra Marie Mccutcheon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619586203
PECOS PAC ID: 5698153070
Enrollment ID: I20220526001729
Provider NameSakolwan Suchartlikitwong
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1790136471
PECOS PAC ID: 1557653565
Enrollment ID: I20220609001356
Provider NameTushar Thakur
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1467829275
PECOS PAC ID: 3476855289
Enrollment ID: I20220802002710
Provider NameHaripriya Maddur
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1821207978
PECOS PAC ID: 4981841590
Enrollment ID: I20220816002604
Provider NameOlivia Betty Aranda
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164151858
PECOS PAC ID: 5698158046
Enrollment ID: I20220817001693
Provider NameAmit Rajaram
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1003341876
PECOS PAC ID: 4981969821
Enrollment ID: I20230523001193
Provider NameSharon Mary Arthur Doherty
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194507640
PECOS PAC ID: 1850741372
Enrollment ID: I20231226001410
Provider NameBriane Jeniene Mape
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083493142
PECOS PAC ID: 7719339829
Enrollment ID: I20240113000329
Provider NameCarissa Ann Gaddie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700617008
PECOS PAC ID: 5092246710
Enrollment ID: I20241007000419
Provider NameDeann Anitra Padilla
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063223923
PECOS PAC ID: 9436675733
Enrollment ID: I20250430000138
Provider NameRaul Garcia Maya
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1962023440
PECOS PAC ID: 4880113570
Enrollment ID: I20250527001382
Provider NameBlake A. Vela
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245950401
PECOS PAC ID: 0244740660
Enrollment ID: I20250605003110
Provider NameAmber Louise Van Dam
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629887260
PECOS PAC ID: 7618488149
Enrollment ID: I20250612003047
Provider NameDavid Kevin Twitchell
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1679215719
PECOS PAC ID: 7113433939
Enrollment ID: I20250718003626
Provider NameKritika Patel
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1023470556
PECOS PAC ID: 2062896566
Enrollment ID: I20250902000859
Provider NameJeremiah M Callahan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144186024
PECOS PAC ID: 0840775490
Enrollment ID: I20260331004706

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.