Individual provider Active NPI

Maria Radulovic, NP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1033570304
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8500 Issued in AZ
Practice address
1515 N 9TH St
Ste B
Phoenix, AZ 85006-2523
Phone
(602) 258-9859
Fax
(480) 214-9945
NPI assigned
Mar 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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 AP8500 AZ Primary

Addresses

Primary practice location

1515 N 9TH St
Ste B
Phoenix, AZ 85006-2523

Mailing address

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258-4583
Phone (480) 455-3000

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
I20160412001814 AZ Practitioner - Nurse Practitioner 3173821907 Reassigns benefits to 3 organizations
Practice locations: Phoenix, AZ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP8500AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
4C Medical Group PLC CurrentSince Sep 1, 2018 Accepting new patients
Unicorn Wings Family CurrentSince Oct 13, 2024 Accepting new patients
4C Medical Group PLC CurrentSince Sep 1, 2018 Accepting new patients
Sjhmc Physician Services CurrentSince Jan 31, 2018 Accepting new patients
Affiliated Hospitalists, PLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

17218 N 72nd Dr
Ste 100
Glendale, AZ 85308
Phone (623) 334-8670

16620 N 40th St
Ste C1
Phoenix, AZ 85032
Phone (602) 923-6666

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

9225 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 870-1821

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258
Phone (480) 272-6400

File 56765
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: maria.radulovic@1028.chartlogic.direct-ci.com
  • Direct secure messaging: maria.radulovic@121801051799556.direct.elationemr.com

Organizations & group practices 6

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": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1033570304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 E IRONWOOD SQUARE DR",
            "address_2": "STE 125",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584583",
            "telephone_number": "480-455-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N 9TH ST",
            "address_2": "STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062523",
            "telephone_number": "602-258-9859",
            "fax_number": "480-214-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADULOVIC",
        "first_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-15",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.