Tiffany Darlene Autrey, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

305685 Issued in AZ

Practice address

1637 N 66TH St
Mesa, AZ 85205-3741

Phone

(951) 581-0998

NPI assigned

May 10, 2024

Last updated

May 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tiffany Darlene Watson Former name

Medicare fee-for-service enrollment

Enrolled in AZ, NV2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Dermright LLCGroup PAC ID 2567707060, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Dermright LLC

  • Dermatology Physician
  • Fountain Hills, AZ
  • NPI 1346725488

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Bruncuso Holdings LLC

  dba GreenWell Health

  • Family Nurse Practitioner
  • Cave Creek, AZ
  • NPI 1497442586

  NV

  Medicare reassignment NPD

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1053169219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 N 66TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053741",
            "telephone_number": "951-581-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 N 66TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053741",
            "telephone_number": "951-581-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTREY",
        "first_name": "TIFFANY",
        "middle_name": "DARLENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "305685",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN209925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WATSON",
            "middle_name": "DARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morris Austin Jr., PHARM.D
• Natalie Austin, MS, LPC
• Robert Brinks Austin, DDS, MD
• Stephanie Austin
• Automated Medication Management
• Gary G Auxier, M.D.
• Av Medical Supplies
• Availlity Hospice
• Andrea Christine Avalos, LAC-T
• Carmen Avalos

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, 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 May 10, 2024; 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.