Individual provider Active NPI

Marytza Olivas-Osuna, FNP-C

  • Family Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1053069369
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
270921 Issued in AZ
Practice address
13055 W McDowell Rd Ste G112
Avondale, AZ 85392-6459
Phone
(623) 322-5900
NPI assigned
Mar 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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 270921 AZ Primary

Addresses

Primary practice location

13055 W McDowell Rd Ste G112
Avondale, AZ 85392-6459

Mailing address

PO Box 6423
Chandler, AZ 85246-6423

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
I20220426001356 AZ Practitioner - Nurse Practitioner 6204223001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

13055 W McDowell Rd
Suite G112
Avondale, AZ 85392-6459
Phone (623) 312-3020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270921AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC CurrentSince Mar 6, 2023 Accepting new patients
Ironwood Physicians, PC CurrentSince Mar 6, 2023 Accepting new patients
4C Medical Group PLC Past Accepting new patients

Locations

13055 W McDowell Rd
Ste G112
Avondale, AZ 85392
Phone (623) 312-3020

5810 W Beverly Ln
Glendale, AZ 85306
Phone (623) 312-3000

1710 N 159th Ave
Goodyear, AZ 85395
Phone (623) 312-3020

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

14810 N Del Webb Blvd
Unit 3
Sun City, AZ 85351
Phone (623) 312-3000

14810 N Del Webb Blvd
Ste 3
Sun City, AZ 85351

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1053069369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13055 W MCDOWELL RD STE G112",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926459",
            "telephone_number": "623-322-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAS-OSUNA",
        "first_name": "MARYTZA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "270921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.