Individual provider Active NPI

Mari Michelle Hooper, NP

  • Gerontology Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1003688417
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RNP299385 Issued in AZ
Practice address
646 S Sabrina
Mesa, AZ 85208-7444
Phone
(480) 628-8370
NPI assigned
Oct 30, 2023
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RNP299385 AZ Primary

Addresses

Primary practice location

646 S Sabrina
Mesa, AZ 85208-7444

Mailing address

646 S Sabrina
Mesa, AZ 85208-7444
Phone (480) 628-8370

Other practice location 1

40 S Kyrene Rd Ste 1
Chandler, AZ 85226-4675
Phone (480) 706-0174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719001191 AZ Practitioner - Nurse Practitioner 2062958606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Consultants P.C.Group PAC ID 4183600539, 32 clinicians

Practice addresses (Care Compare)

6750 E Baywood Ave
Suite 401
Mesa, AZ 85206-1749
Phone 4808357111112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RNP299385AZMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Consultants P C Current Accepting new patients
Pulmonary Consultants P.C. CurrentSince Sep 6, 2024 Accepting new patients

Locations

6750 E Baywood Ave
Ste 401
Mesa, AZ 85206
Phone (480) 835-7111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19484/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DBCHBD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1003688417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S SABRINA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852087444",
            "telephone_number": "480-628-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S SABRINA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852087444",
            "telephone_number": "480-628-8370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 S Kyrene Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852264675",
            "country_code": "US",
            "telephone_number": "480-706-0174",
            "fax_number": "480-706-0117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "MARI",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "RNP299385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.