Individual provider Active NPI

Sandra Garrett-Shorty, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1255737656
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP7280 Issued in AZ
Practice address
1301 S Crismon Rd
Mesa, AZ 85209-3767
Phone
(480) 358-6100
NPI assigned
Nov 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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 TAP7280 AZ Primary

Addresses

Primary practice location

1301 S Crismon Rd
Mesa, AZ 85209-3767

Mailing address

1301 S Crismon Rd
Mesa, AZ 85209-3767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170811000985 TX Practitioner - Nurse Practitioner 6507137304 Reassigns benefits to 1 organization
I20240102003816 AZ Practitioner - Nurse Practitioner 6507137304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
65.27 of 100Reported as group
Quality
45.09
Improvement activities
40
Cost
66.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP7280AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation CurrentSince Jul 3, 2017 Accepting new patients
Gila River Health Care CurrentSince Jul 3, 2017 Accepting new patients
Upward Health of Arizona LLC CurrentSince Jan 3, 2025 Accepting new patients
Dispatchhealth-Arizona CurrentSince Dec 14, 2023 Accepting new patients
Dispatchhealth-Arizona CurrentSince Dec 14, 2023 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients

Locations

4602 E University Dr
Ste 150
Phoenix, AZ 85034
Phone (480) 493-3444

2760 W Peoria Ave
Phoenix, AZ 85029
Phone (309) 229-0799

80 Arkay Dr
Ste 230
Hauppauge, NY 11788
Phone (631) 540-8225

Interoperability endpoints

  • Direct secure messaging: sandra.garrett-shorty@mfamd-az.direct.office.nextgen.com
  • Direct secure messaging: sandra.garrett-shorty.1@15578.direct.athenahealth.com

Organizations & group practices 6

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": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1255737656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "480-358-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT-SHORTY",
        "first_name": "SANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP7280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.