Phillip Prusinski, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9609 Issued in AZ

Practice address

4350 N 19TH Ave
#6
Phoenix, AZ 85015-4602

Phone

(480) 607-1124

NPI assigned

Nov 4, 2016

Last updated

Nov 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pueblo Family Physicians LTDGroup PAC ID 2062497936, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pueblo Family Physicians LTD

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1790798072
  Medicare reassignment Care Compare group NPD
• Footcare Center - Dr. Mark Gorman, PC

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
  • NPI 1033325097
  NPD (past)

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1033661244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE",
            "address_2": "#6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "480-607-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE",
            "address_2": "#6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "480-607-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSINSKI",
        "first_name": "PHILLIP",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher R Pruitt, M.D.
• Randall C Pruitt, DC
• Rhonda Lee Pruitt, LPC, LISAC
• Brianna Pruniski, MMSC
• Mark G Prusacki, DDS
• Misty Pryor-Meininger
• Judy Pryor, R.N.
• Kendra Pryor
• Nicole Pryor
• Stephanie E Pryor, MPT

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.