Individual provider Active NPI

Derek B Eason, AGNP-C

  • Primary Care Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1063272334
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
305255 Issued in AZ
Practice address
1492 S Mill Ave Ste 212
Tempe, AZ 85281-5664
Phone
(480) 410-4128
Fax
(480) 410-4130
NPI assigned
Mar 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 305255 AZ Primary

Addresses

Primary practice location

1492 S Mill Ave Ste 212
Tempe, AZ 85281-5664

Mailing address

1675 E Morten Ave Unit 1120
Phoenix, AZ 85020-4639
Phone (801) 694-5382

Other practice location 1

3402 N Central Ave
Phoenix, AZ 85012-2202
Phone (480) 410-4129

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
I20240422002339 AZ Practitioner - Nurse Practitioner 9830538966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Be Well Family CareGroup PAC ID 2163844986, 9 clinicians

Practice addresses (Care Compare)

1492 S Mill Aveune
Suite 212
Tempe, AZ 85281-5664
Phone (480) 410-4128

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well Family Care CurrentSince Mar 20, 2024 Accepting new patients

Locations

3402 N Central Ave
Phoenix, AZ 85012
Phone (480) 410-4128

7000 N 16th St
#120228
Phoenix, AZ 85020

10446 N 74th St
Ste 140
Scottsdale, AZ 85258
Phone (602) 441-2778

1492 S Mill Ave
Ste 212
Tempe, AZ 85281
Phone (480) 410-4128

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22341/brand/1/csg/1/fhir/r4
  • Direct secure messaging: derek.eason.1@22341.direct.athenahealth.com

Organizations & group practices 1

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": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1063272334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E MORTEN AVE UNIT 1120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204639",
            "telephone_number": "801-694-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 S MILL AVE STE 212",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852815664",
            "telephone_number": "480-410-4128",
            "fax_number": "480-410-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3402 N Central Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122202",
            "country_code": "US",
            "telephone_number": "480-410-4129",
            "fax_number": "480-410-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASON",
        "first_name": "DEREK",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "305255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.