Individual provider Active NPI

Daniela Graciano, FNP

  • Family Nurse Practitioner
  • San Luis, AZ
National Provider Identifier
1114890571
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
323941 Issued in AZ
Practice address
151 S Oak Ave Ste 7
San Luis, AZ 85336-0756
Phone
(928) 366-5166
Fax
(928) 366-5165
NPI assigned
Sep 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 323941 AZ Primary

Addresses

Primary practice location

151 S Oak Ave Ste 7
San Luis, AZ 85336-0756

Mailing address

PO Box 617
Somerton, AZ 85350-0617
Phone (928) 662-0406

Other practice location 1

1233 N Main St # 1A
San Luis, AZ 85336-0663
Phone (928) 550-5514

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
I20260320003331 AZ Practitioner - Nurse Practitioner 4183108756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Luis Walk-in Clinic IncGroup PAC ID 2668361841, 49 clinicians

Practice addresses (Care Compare)

1233 N Main St
Suite 1a
San Luis, AZ 85336-0663
Phone (928) 550-5514

151 S Oak Ave
San Luis, AZ 85336-0756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
323941AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1114890571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-662-0406",
            "fax_number": "928-662-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S OAK AVE STE 7",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853360756",
            "telephone_number": "928-366-5166",
            "fax_number": "928-366-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 N Main St # 1A",
            "address_purpose": "LOCATION",
            "city": "San Luis",
            "state": "AZ",
            "postal_code": "853360663",
            "country_code": "US",
            "telephone_number": "928-550-5514",
            "fax_number": "928-550-5160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACIANO",
        "first_name": "DANIELA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "323941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

Verify at the official NPI Registry.