Mathena Jardine, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

279035 Issued in AZ

Practice address

2640 W Baseline Rd Ste 111
Phoenix, AZ 85041-6492

Phone

(480) 677-8282

NPI assigned

Aug 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Good Health Medical PLLC 215 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

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.

• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432

  AZ

  Medicare reassignment Care Compare group NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1740545375
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • San Tan Valley, AZ
  • NPI 1063573079
  NPD (past)
• Premier OBGYN LLC

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
  • NPI 1487035382
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1265160378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W BASELINE RD STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416492",
            "telephone_number": "480-677-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "MATHENA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andres Nicholas Jaramillo, LPC
• Cecelia Jaramillo
• Ernest Jaramillo
• Keith Alan Jarbo, M.D.
• Douglas Seymour Jardine Jr., PHD, LMFT
• Sandy Jardine, M.S.
• Jareko LLC
• Lisa Jarnagin
• Dawn E Jaroszewski, M.D.
• Randa Jarrar, MD

• All providers in Phoenix, AZ
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.
• 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.

Verify at the official NPI Registry.