Jesus M Arballo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

218325 Issued in AZ

Practice address

1620 E Wilcox Dr
Sierra Vista, AZ 85635-2778

Phone

(520) 459-0362

Fax

(520) 458-1585

NPI assigned

Oct 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

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.

• Patel Medical Clinic, PLLC

  • Internal Medicine Physician
  • Sierra Vista, AZ
  • NPI 1720303563
  Medicare reassignment NPD

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1053887133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352778",
            "telephone_number": "520-459-0362",
            "fax_number": "520-458-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352778",
            "telephone_number": "520-459-0362",
            "fax_number": "520-458-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBALLO",
        "first_name": "JESUS",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "218325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jesus-arballo@patelmedicalclinic.e-mdsdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1620 E Wilcox Dr",
            "city": "Sierra Vista",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "856352778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angelo a Petropolis MD PLLC
• Ayesh Anwar, MD
• Apexnetwork Sierra Vista, PLLC
• Apricity Intergrated Behavioral Healthcare LLC (Apricity Itegrated Behavioral Healthcare)
• Sami Aqqad, M.D.
• Brandy Arellano, CNM
• Sherri Arenas, LPC
• Arete Sleep LLC
• Arete Sleep Therapy LLC
• Arizona Ambulance of Douglas Inc (Arizona Ambulance Transportation)

• Family Nurse Practitioner in Sierra Vista, AZ
• Providers in Sierra Vista, 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 Apr 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.