Individual provider Active NPI

Juliana Mandat, FNP-C

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1295419646
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
227771 Issued in AZ
Practice address
5010 E Shea Blvd Ste 200
Scottsdale, AZ 85254-4189
Phone
(480) 219-3594
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 227771 AZ Primary

Addresses

Primary practice location

5010 E Shea Blvd Ste 200
Scottsdale, AZ 85254-4189

Mailing address

1120 E Fern Dr N
Phoenix, AZ 85014-3245

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231108001735 AZ Practitioner - Nurse Practitioner 6507213816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Donald E Paxton MD LLCGroup PAC ID 3971510090, 2 clinicians

Practice addresses (Care Compare)

202 E Earll Dr
Suite 450
Phoenix, AZ 85012-2675
Phone (602) 241-9500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227771AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Donald E Paxton MD LLC CurrentSince Oct 26, 2023 Accepting new patients

Locations

202 E Earll Dr
Ste 450
Phoenix, AZ 85012
Phone (602) 241-9500

Organizations & group practices 1

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1295419646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E FERN DR N",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 E SHEA BLVD STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544189",
            "telephone_number": "480-219-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAT",
        "first_name": "JULIANA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "227771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.