Stephanie Deborah Kotsur, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP11222 Issued in AZ

Practice address

21321 E Ocotillo Rd Ste 133
Queen Creek, AZ 85142-5995

Phone

(480) 987-5525

Fax

(480) 987-5115

NPI assigned

May 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHBEDD/Endpoint/BHBEDD

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.

• Allied Internal Medicine PLLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1124408232
  Medicare reassignment NPD

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

{
    "created_epoch": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1235620170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 133",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "480-987-5525",
            "fax_number": "480-987-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 133",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "480-987-5525",
            "fax_number": "480-987-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSUR",
        "first_name": "STEPHANIE",
        "middle_name": "DEBORAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-26",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AP11222",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP11222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kivisto, FNP
• Michelle Marie Klym, B.S., SLP-A
• Meghan Knife, PHARM.D.
• Alfred Knight
• Laura Kobar, MS, MC, LPC
• Kellie M Kotwicki, MS, BCBA, LBA
• Cory M Kovac, PA-C
• Madison Christine Kowalski, PA-C
• Mindy Kraus, M.ED, BCBA, LBA
• Drew Ann Krempin, RN

• Primary Care Nurse Practitioner in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.