Individual provider Active NPI

Lino Ossanna, M.D.

  • Obstetrics & Gynecology Physician
  • Queen Creek, AZ
National Provider Identifier
1003849514
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33661 Issued in AZ
Practice address
21321 E Ocotillo Rd
Suite 127
Queen Creek, AZ 85242-5996
Phone
(480) 888-7271
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33661 AZ Primary

Addresses

Primary practice location

21321 E Ocotillo Rd
Suite 127
Queen Creek, AZ 85242-5996

Mailing address

280 W Sparrow Dr
Chandler, AZ 85248-2758
Phone (480) 963-7900

Other identifiers 1

IdentifierTypeStateIssuer
922428MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050331000724 AZ Practitioner - Obstetrics/Gynecology 8527020387 Reassigns benefits to 2 organizations
I20171227002759 OR Practitioner - Obstetrics/Gynecology 8527020387 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
234275NYMDLicensed Practical Nurse
33661AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Valley Healthcare Inc CurrentSince Nov 3, 2017 Accepting new patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Nov 3, 2017 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Sierra Vista Regional Health Center Medical Group LLC Obstetrics & Gynecology CurrentSince Dec 7, 2017 Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Banner Ironwood Medical Center Past Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
Women's Health Now PLLC PastSince Jul 1, 2007 Accepting new patients
Harry C Watters DO MPH PC Obstetrics & Gynecology Past Accepting new patients

Locations

5750 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Ste 300B
Sierra Vista, AZ 85635
Phone (520) 263-3620

300 El Camino Real
Sierra Vista, AZ 85635
Phone (520) 417-4594

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

675 N 5th St
Lebanon, OR 97355
Phone (541) 451-6282

Networks

  • NM HMO C-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIAIAD/Endpoint/JIAIAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CEJIBD/Endpoint/CEJIBD
  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1003849514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W SPARROW DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852482758",
            "telephone_number": "480-963-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "address_2": "SUITE 127",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852425996",
            "telephone_number": "480-888-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSANNA",
        "first_name": "LINO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "33661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922428",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.