Rosemary T Mayordo, FOSTER HOME

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11408F Issued in AZ

Practice address

21210 W Holly St
Buckeye, AZ 85396-2367

Phone

(206) 383-3905

NPI assigned

Apr 29, 2020

Last updated

Apr 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• At-Home at Sienna Hills LLC Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunset Vista First LLC

  • Adult Care Home Facility
  • Phoenix, AZ
  • NPI 1053053900
  NPD

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1225659493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21210 W HOLLY ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853962367",
            "telephone_number": "206-383-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 W HOLLY ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853962367",
            "telephone_number": "206-383-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORDO",
        "first_name": "ROSEMARY",
        "middle_name": "T",
        "credential": "FOSTER HOME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL11408F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AT-HOME AT SIENNA",
            "last_name": "LLC",
            "middle_name": "HILLS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Evans Masese
• David Michael Mattiuz Jr., RN
• Shane Michael Maule, DDS
• Max Homecare LLC
• Dawn Michelle Maxwell, FNP-C
• Victoria Violet McBerty, FNP-BC
• Blake Keith McDonald, PT, DPT
• Chelsea A McManamy
• Susan McMillan
• Ryan Dean McNeely

• Assisted Living Facility in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.