Individual provider Active NPI

Martha Elizabeth Van Driel, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1053071613
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
301086 Issued in AZ
Practice address
7350 E 22ND St
Tucson, AZ 85710-6427
Phone
(520) 771-8389
Fax
(520) 771-9339
NPI assigned
Dec 23, 2021
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 301086 AZ Primary
Community Health Registered Nurse 163WC1500X 208030 AZ

Addresses

Primary practice location

7350 E 22ND St
Tucson, AZ 85710-6427

Mailing address

7350 E 22ND St
Tucson, AZ 85710-6427
Phone (520) 771-8389

Other practice location 1

5956 E Pima St Ste 120
Tucson, AZ 85712-4375
Phone (520) 372-7489

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
I20240709002887 AZ Practitioner - Nurse Practitioner 3678018108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saguaro Pain Management PLLCGroup PAC ID 7214328095, 2 clinicians

Practice addresses (Care Compare)

7350 E 22ND St
Tucson, AZ 85710-6427
Phone (520) 771-8389

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208030AZMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Saguaro Pain Management, PLLC CurrentSince May 31, 2024 Accepting new patients
Drexzell Primary Care, PLLC CurrentSince May 26, 2024 Accepting new patients

Locations

7350 E 22nd St
Tucson, AZ 85710
Phone (520) 296-3999

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIGGCD/Endpoint/IIGGCD

Organizations & group practices 2

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": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1053071613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 E 22ND ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857106427",
            "telephone_number": "520-771-8389",
            "fax_number": "520-771-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 E 22ND ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857106427",
            "telephone_number": "520-771-8389",
            "fax_number": "520-771-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5956 E Pima St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857124375",
            "country_code": "US",
            "telephone_number": "520-372-7489",
            "fax_number": "520-622-1028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DRIEL",
        "first_name": "MARTHA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "301086",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "AZ",
            "license": "208030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.