Individual provider Active NPI

Janise W Luna-Benally, APRN, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1295509214
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
297124 Issued in AZ
Practice address
3838 E Van Buren St
Phoenix, AZ 85008-6918
Phone
(602) 243-7277
NPI assigned
Nov 9, 2023
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 297124 AZ Primary

Addresses

Primary practice location

3838 E Van Buren St
Phoenix, AZ 85008-6918

Mailing address

1839 N Sandal
Mesa, AZ 85205-3581
Phone (480) 294-3082

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
I20240328003062 AZ Practitioner - Nurse Practitioner 0547607335 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
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

3830 E Van Buren St
Phoenix, AZ 85008-6920
Phone (602) 243-7277

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Jan 31, 2024 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Jan 31, 2024 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

3830 E Van Buren St
Phoenix, AZ 85008
Phone (602) 806-6655

635 E Baseline Rd
Phoenix, AZ 85042

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1295509214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 N SANDAL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053581",
            "telephone_number": "480-294-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086918",
            "telephone_number": "602-243-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA-BENALLY",
        "first_name": "JANISE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "297124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.