Active NPI
Samantha Joette Kuroski
- Psychiatric Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1295644185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Residential Treatment Facility
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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.