Individual provider Active NPI

Samantha Joette Kuroski

  • Psychiatric Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1295644185
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Practice address
12 W Vernon Ave
Phoenix, AZ 85003-1039
Phone
(406) 207-7859
NPI assigned
Sep 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X AZ
Substance Abuse Rehabilitation Facility 324500000X AZ
Psychiatric Residential Treatment Facility 323P00000X AZ Primary

Addresses

Primary practice location

12 W Vernon Ave
Phoenix, AZ 85003-1039

Mailing address

12 W Vernon Ave
Phoenix, AZ 85003-1039

Other names 1

  • Jesse Andre Martinez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1295644185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W VERNON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W VERNON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031039",
            "telephone_number": "406-207-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUROSKI",
        "first_name": "SAMANTHA",
        "middle_name": "JOETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "MARTINEZ",
            "middle_name": "ANDRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.