Individual provider Active NPI

Marie Noelle M Recalde, FNP-C

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1184340887
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
281973 Issued in AZ
Practice address
612 W Baseline Rd
Mesa, AZ 85210-6041
Phone
(480) 834-9039
NPI assigned
Oct 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 281973 AZ Primary

Addresses

Primary practice location

612 W Baseline Rd
Mesa, AZ 85210-6041

Mailing address

1232 W Falls Canyon Dr
Casa Grande, AZ 85122-6668
Phone (520) 280-3035

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
I20221228001041 AZ Practitioner - Nurse Practitioner 4587034020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Kidney Associates PLCGroup PAC ID 4284611286, 27 clinicians

Practice addresses (Care Compare)

612 W Baseline Rd
Mesa, AZ 85210-6041
Phone (480) 834-9039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Kidney Associates PLC CurrentSince Dec 1, 2022 Accepting new patients
Bio-Medical Applications of Arizona, LLC Past Accepting new patients
Renal Dimensions, LLC Past Accepting new patients

Locations

5200 E Cortland Blvd
Ste A4
Flagstaff, AZ 86004
Phone (928) 527-4990

612 W Baseline Rd
Mesa, AZ 85210
Phone (310) 940-4170

3124 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 371-4700

22715 S Ellsworth Rd
Bldg G
San Tan Valley, AZ 85142
Phone (480) 677-2463

2022 E Prince Rd
Tucson, AZ 85719
Phone (520) 327-0007

Interoperability endpoints

  • Direct secure messaging: mrecalde51422@direct.acumenmd.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.

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1184340887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 W FALLS CANYON DR",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226668",
            "telephone_number": "520-280-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106041",
            "telephone_number": "480-834-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECALDE",
        "first_name": "MARIE NOELLE",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "281973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.