Active NPI
Michelle Iliescu, DNP, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Avondale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 292946
- Practice address
- 506 E Western Ave Ste 104
Avondale, AZ 85323-2422 - Phone
- (602) 230-7373
- NPI assigned
- Jun 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 292946 | AZ | Primary |
Addresses
Primary practice location
506 E Western Ave Ste 104
Avondale, AZ 85323-2422
Mailing address
235 W Western Ave
Avondale, AZ 85323-1848
Phone (623) 244-2960
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
750 E Thunderbird Rd
1 3
Phoenix, AZ 85022-5306
Phone (602) 230-7373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 292946 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denova Collaborative Health, LLC | Current | Accepting new patients | |
| Denova Collaborative Health, LLC | Current | Accepting new patients | |
| Denova Collaborative Health, LLC | Current | Accepting new patients |
Locations
235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091
506 E Western Ave
Ste 104
Avondale, AZ 85323
2204 S Dobson Rd
Ste 102
Mesa, AZ 85202
750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455
3101 N Central Ave
Ste 500
Phoenix, AZ 85012
750 E Thunderbird Rd
#13
Phoenix, AZ 85022
3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289
750 E Thunderbird Rd
Ste 1
Phoenix, AZ 85022
Phone (602) 942-8512
Interoperability endpoints
- denova.michelleiliescu@141317.advancedmd-direct.com
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1609300854
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1710283593
-
- Multi-Specialty Clinic/Center
- Peoria, AZ
- NPI 1740079060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1245924653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 W WESTERN AVE",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853231848",
"telephone_number": "623-244-2960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 E WESTERN AVE STE 104",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853232422",
"telephone_number": "602-230-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILIESCU",
"first_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "DNP, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-07",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "292946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.