Individual provider Active NPI

Elisabet Prieto, ARNP

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1285630657
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP 2786372 Issued in FL
Practice address
1920 E Cambridge Ave
Suite 301
Phoenix, AZ 85006-1459
Phone
(602) 253-6000
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP 2786372 FL Primary
Pediatric Nurse Practitioner 363LP0200X AP2694 FL

Addresses

Primary practice location

1920 E Cambridge Ave
Suite 301
Phoenix, AZ 85006-1459

Mailing address

16023 N 19TH Dr
Phoenix, AZ 85023-7280
Phone (305) 804-3903

Other identifiers 1

IdentifierTypeStateIssuer
3051188-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20130612000432 VA Order and Referring Only - Nurse Practitioner 2961501325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP2694FLMDPediatric Nurse Practitioner
ARNP 2786372FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Phoenix PC Past Accepting new patients
Obstetrix Medical Group of Phoenix PC Past Accepting new patients

Organizations & group practices 2

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1285630657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16023 N 19TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850237280",
            "telephone_number": "305-804-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE",
            "address_2": "SUITE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061459",
            "telephone_number": "602-253-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO",
        "first_name": "ELISABET",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP 2786372",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "AP2694",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3051188-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.