Individual provider Active NPI

Jody L Pelusi, N.P

  • Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1053352450
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN032327 Issued in AZ
Practice address
10510 N 92ND St
Suite 200
Scottsdale, AZ 85258-4566
Phone
(480) 323-1350
Fax
(480) 323-1359
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN032327 AZ Primary

Addresses

Primary practice location

10510 N 92ND St
Suite 200
Scottsdale, AZ 85258-4566

Mailing address

2500 W Utopia Rd
Suite100
Phoenix, AZ 85027-4171
Phone (623) 434-6200

Other identifiers 1

IdentifierTypeStateIssuer
333310MedicaidAZ

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
I20120125000961 AZ Practitioner - Nurse Practitioner 8527235993 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN032327AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC CurrentSince Jun 13, 2016 Accepting new patients
John C. Lincoln, LLC CurrentSince Jun 13, 2016 Accepting new patients
Honorhealth Medical Group, LLC Current Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 13, 2016 Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 13, 2016 Accepting new patients
Arizona Oncology Services Inc Past Accepting new patients

Locations

6220 W Bell Rd
Ste 100
Glendale, AZ 85308
Phone (602) 547-7200

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1053352450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "address_2": "SUITE100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "623-434-6200",
            "fax_number": "623-434-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 N 92ND ST",
            "address_2": "SUITE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584566",
            "telephone_number": "480-323-1350",
            "fax_number": "480-323-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELUSI",
        "first_name": "JODY",
        "middle_name": "L",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN032327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333310",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.