Individual provider Active NPI

Carmela Marfori Fernandez, FNP-C

  • Family Nurse Practitioner
  • Buckeye, AZ
National Provider Identifier
1013633643
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
282590 Issued in AZ
Practice address
525 S Watson Rd Ste 200
Buckeye, AZ 85326-3451
Phone
(623) 385-7900
NPI assigned
Oct 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 282590 AZ Primary

Addresses

Primary practice location

525 S Watson Rd Ste 200
Buckeye, AZ 85326-3451

Mailing address

525 S Watson Rd Ste 200
Buckeye, AZ 85326-3451

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
I20221130001666 AZ Practitioner - Nurse Practitioner 2961870613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

525 S Watson Rd
Suite 200
Buckeye, AZ 85326-3451
Phone (602) 726-8750

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282590AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Oct 3, 2023 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Oct 3, 2023 Accepting new patients
Healthy Life Corporation CurrentSince Oct 31, 2022 Accepting new patients

Locations

525 S Watson Rd
Ste 200
Buckeye, AZ 85326
Phone (602) 726-8750

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

10240 W Indian School Rd
Ste 155
Phoenix, AZ 85037
Phone (623) 385-7900

4338 W Thomas Rd
Ste 116
Phoenix, AZ 85031
Phone (623) 385-7900

Interoperability endpoints

  • Direct secure messaging: carmela.fernandez.1@600.direct.athenahealth.com

Organizations & group practices 3

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": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1013633643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S WATSON RD STE 200",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S WATSON RD STE 200",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263451",
            "telephone_number": "623-385-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CARMELA",
        "middle_name": "MARFORI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "282590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

Verify at the official NPI Registry.