Individual provider Active NPI

Cathryn Griepentrog

  • Gerontology Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1104402114
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
246235 Issued in AZ
Practice address
7227 E Baseline Rd Ste 129
Mesa, AZ 85209-5006
Phone
(435) 514-5646
NPI assigned
Mar 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 246235 AZ Primary

Addresses

Primary practice location

7227 E Baseline Rd Ste 129
Mesa, AZ 85209-5006

Mailing address

PO Box 4682
Logan, UT 84323-4682
Phone (435) 514-5646

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
I20210730002339 AZ Practitioner - Nurse Practitioner 6709289564 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Medical Aco LLCGroup PAC ID 1456885227, 50 clinicians
Century Care IncGroup PAC ID 3971665605, 51 clinicians

Practice addresses (Care Compare)

7227 E Baseline Rd
Suite 126
Mesa, AZ 85209-5006
Phone (480) 868-9650

Hospital & facility affiliations

  • Aegis Homecare, Inc Home health agency, Mesa, AZ, CCN 037422
  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Aegis Hospice, Inc. Hospice, Mesa, AZ, CCN 031613

Merit-based Incentive Payment System (MIPS)

Final score
77.24 of 100Reported as group
Quality
66.21
Improvement activities
40
Cost
66.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246235AZMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Century Care Inc Geriatric Medicine CurrentSince Feb 15, 2022 Accepting new patients
Allied Internal Medicine PLLC CurrentSince Jul 1, 2021 Accepting new patients
Atlas Medical Aco LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

2012 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 938-0700

3319 S Mercy Rd
Gilbert, AZ 85297
Phone (480) 729-6500

7227 E Baseline Rd
Ste 126
Mesa, AZ 85209
Phone (907) 215-4846

215 S Power Rd
Mesa, AZ 85206
Phone (480) 945-7711

Interoperability endpoints

  • Direct secure messaging: cathryn.griepentrog@57560418353156.direct.elationemr.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1104402114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4682",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843234682",
            "telephone_number": "435-514-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 E BASELINE RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095006",
            "telephone_number": "435-514-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEPENTROG",
        "first_name": "CATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "246235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.