Vincent P Ekstrom, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

242271 Issued in AZ

Practice address

18628 N 43Rd St
Phoenix, AZ 85050-3342

Phone

(602) 489-9606

NPI assigned

Jun 19, 2020

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

Other identifiers 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mind 247 Practice LLCGroup PAC ID 6406253541, 33 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Mind 247 Practice LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1902472467

  AZ

  Medicare reassignment Care Compare group NPD
• Mind 247 Practice LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1659089951
  NPD

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1124644794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18628 N 43RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503342",
            "telephone_number": "602-489-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18628 N 43RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503342",
            "telephone_number": "602-489-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKSTROM",
        "first_name": "VINCENT",
        "middle_name": "P",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-19",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "242271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081286",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Ekeoma
• Queendoline Unyime Ekpo, ANP-BC
• Deepali D Eksambe, M.D
• Brandi Ekstrom, C.O.A., S.T.
• Katherine Anne Ekstrom, MS-SLP
• Desiree Ekundayo
• Akua Ekunwe, MD
• Shakir El Sharf El Day
• Ahmad El Khatib
• Ramy El Mankabady, DO

• All providers in Phoenix, AZ
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.