Individual provider Active NPI

Mandy Moreno, FNP

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1225491053
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8565 Issued in AZ
Practice address
2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone
(928) 341-0700
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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 AP8565 AZ Primary

Addresses

Primary practice location

2775 S 8TH Ave
Yuma, AZ 85364-7110

Mailing address

2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone (928) 341-0700

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
I20160628001762 AZ Practitioner - Nurse Practitioner 3870884570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Up2Par PLLCGroup PAC ID 7416955745, 14 clinicians

Practice addresses (Care Compare)

2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone (928) 341-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Up2Par PLLC CurrentSince Apr 19, 2016 Accepting new patients

Locations

11463 S Foothills Blvd
Yuma, AZ 85367
Phone (928) 955-0189

2775 S 8th Ave
Yuma, AZ 85364
Phone (928) 341-0700

1025 W 24th St
Ste 18
Yuma, AZ 85364
Phone (928) 341-0700

Organizations & group practices 1

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 4

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1225491053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 S 8TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647110",
            "telephone_number": "928-341-0700",
            "fax_number": "928-341-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 S 8TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647110",
            "telephone_number": "928-341-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MANDY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.