Individual provider Active NPI

Nancy Mucha, CNP

  • Adult Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1063814879
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP7292 Issued in AZ
Practice address
2843 N 89TH St
Mesa, AZ 85207-4278
Phone
(480) 396-3482
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AP7292 AZ
Adult Health Nurse Practitioner 363LA2200X AP7292 AZ Primary

Addresses

Primary practice location

2843 N 89TH St
Mesa, AZ 85207-4278

Mailing address

201 W Guadalupe Rd
Ste 200
Gilbert, AZ 85233-3327
Phone (480) 219-6631

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
I20150508000215 AZ Practitioner - Nurse Practitioner 9335468610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 W Guadalupe Rd
Suite 200
Gilbert, AZ 85233-3327
Phone (480) 219-6631

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP7292AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gilbert Complete Medical Clinic LLC Single Specialty CurrentSince Oct 28, 2024 Accepting new patients

Locations

201 W Guadalupe Rd
Ste 200
Gilbert, AZ 85233
Phone (480) 219-6631

201 W Guadalupe Rd
Ste 201
Gilbert, AZ 85233
Phone (480) 782-7705

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1063814879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W GUADALUPE RD",
            "address_2": "STE 200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333327",
            "telephone_number": "480-219-6631",
            "fax_number": "480-247-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 N 89TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852074278",
            "telephone_number": "480-396-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCHA",
        "first_name": "NANCY",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AP7292",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP7292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.