Individual provider Active NPI

Julie Marie Polzin, RN, NP-C

  • Family Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1033494901
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4224 Issued in AZ
Practice address
107 E Oak Ave
Suite 201
Flagstaff, AZ 86001-1818
Phone
(928) 913-8800
Fax
(928) 913-8801
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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 AP4224 AZ Primary

Addresses

Primary practice location

107 E Oak Ave
Suite 201
Flagstaff, AZ 86001-1818

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 773-2559

Other identifiers 1

IdentifierTypeStateIssuer
669147MedicaidAZ

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
I20120329000213 AZ Practitioner - Nurse Practitioner 2860652872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4224AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Medical Center CurrentSince Jan 12, 2012 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 14, 2018 Accepting new patients
Flagstaff Medical Center CurrentSince Jan 12, 2012 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 14, 2018 Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

340 S Willard St
Ste 101
Cottonwood, AZ 86326
Phone (928) 639-2015

2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

107 E Oak Ave
Ste 201
Flagstaff, AZ 86001
Phone (928) 380-5689

1050 N San Francisco St
Flagstaff, AZ 86001
Phone (928) 214-3802

7810 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 522-8375

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1033494901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-773-2559",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "address_2": "SUITE 201",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-913-8800",
            "fax_number": "928-913-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIN",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "669147",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.