Individual provider Active NPI

Jerrid Lujan

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1043142268
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP340098 Issued in AZ
Practice address
7525 E Broadway Rd
Mesa, AZ 85208-2002
Phone
(480) 981-2700
NPI assigned
Jun 1, 2026
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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 RNP340098 AZ Primary

Addresses

Primary practice location

7525 E Broadway Rd
Mesa, AZ 85208-2002

Mailing address

4247 E Betsy LN
Gilbert, AZ 85296-9626
Phone (330) 501-1154

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
I20260625002445 AZ Practitioner - Nurse Practitioner 5092288548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21410 N 19TH Ave
Suite 151
Phoenix, AZ 85027-2761

3030 N Central Ave
Suite 1106
Phoenix, AZ 85012-2718

4247 E Betsy LN
Gilbert, AZ 85296-9626

6309 E Baywood Ave
Suite 101
Mesa, AZ 85206-1726

PO Box
Suite 39334
Phoenix, AZ 85069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNP340098AZMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1043142268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 E BETSY LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852969626",
            "telephone_number": "330-501-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082002",
            "telephone_number": "480-981-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJAN",
        "first_name": "JERRID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP340098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.