Individual provider Active NPI

Nikolas Enrique Ramos

  • Psychiatric/Mental Health Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1205678331
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023129979 Issued in AZ
Practice address
5527 S Mitchell Dr
Tempe, AZ 85283-1775
Phone
(520) 409-9429
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023129979 AZ Primary

Addresses

Primary practice location

5527 S Mitchell Dr
Tempe, AZ 85283-1775

Mailing address

5527 S Mitchell Dr
Tempe, AZ 85283-1775
Phone (520) 409-9429

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
I20240812000873 AZ Practitioner - Nurse Practitioner 8820536709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leading Healthcare Specialist PLLCGroup PAC ID 6002246352, 20 clinicians

Practice addresses (Care Compare)

12622 E Victoria St
Chandler, AZ 85249-3748
Phone (623) 295-1190

Hospital & facility affiliations

  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023129979AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MPVP Psychiatry Psychiatric/Mental Health CurrentSince Jun 16, 2024 Accepting new patients
Leading Healthcare Clinic of Goodyear LLC Psychiatric/Mental Health CurrentSince Jul 15, 2024 Accepting new patients
Leading Healthcare Specialist PLLC Psychiatric/Mental Health CurrentSince Jul 15, 2024 Accepting new patients

Locations

13555 W McDowell Rd
Ste 205
Goodyear, AZ 85395
Phone (623) 535-0740

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 1

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1205678331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5527 S MITCHELL DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831775",
            "telephone_number": "520-409-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 S MITCHELL DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831775",
            "telephone_number": "520-409-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "NIKOLAS",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "2023129979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.