Individual provider Active NPI

Katressa Suzanne Regione

  • Family Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1215658653
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
253643 Issued in AZ
Practice address
21323 S Ellsworth Loop Rd Ste 101
Queen Creek, AZ 85142-9865
Phone
(480) 307-8440
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 253643 AZ
Family Nurse Practitioner 363LF0000X 253643 AZ Primary

Addresses

Primary practice location

21323 S Ellsworth Loop Rd Ste 101
Queen Creek, AZ 85142-9865

Mailing address

PO Box 6610
Chandler, AZ 85246-6610
Phone (480) 307-8440

Other names 1

  • Katressa Suzanne Pinnon Former name

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
I20250430003481 AZ Practitioner - Nurse Practitioner 0749706950 Reassigns benefits to 1 organization

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
Ellsworth Medical Group LLCGroup PAC ID 4082959267, 5 clinicians

Practice addresses (Care Compare)

21323 S Ellsworth Loop Rd
Suite 101
Queen Creek, AZ 85142-9865
Phone (480) 307-8440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253643AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ellsworth Medical Group LLC CurrentSince Apr 1, 2025 Accepting new patients
QC Valley Medical Centers, LLC Past Accepting new patients

Locations

21323 S Ellsworth Loop Rd
Queen Creek, AZ 85142

21323 S Ellsworth Loop Rd
Ste 101
Queen Creek, AZ 85142
Phone (480) 307-8440

Organizations & group practices 2

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1215658653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6610",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466610",
            "telephone_number": "480-307-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21323 S ELLSWORTH LOOP RD STE 101",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429865",
            "telephone_number": "480-307-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIONE",
        "first_name": "KATRESSA",
        "middle_name": "SUZANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "253643",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "253643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRESSA",
            "last_name": "PINNON",
            "middle_name": "SUZANNE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.