Individual provider Active NPI

Diamond Mercedes Chavez

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1366293227
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
305575 Issued in AZ
Practice address
9315 W Orange Dr
Glendale, AZ 85305-3376
Phone
(480) 257-0709
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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 305575 AZ Primary

Addresses

Primary practice location

9315 W Orange Dr
Glendale, AZ 85305-3376

Mailing address

9315 W Orange Dr
Glendale, AZ 85305-3376
Phone (480) 257-0709

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
I20240918000527 AZ Practitioner - Nurse Practitioner 5092256099 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain and Palliative Associates of Arizona CurrentSince Aug 14, 2024 Accepting new patients
Valley Geriatric Associates PLLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

4202 N 20th Ave
Phoenix, AZ 85015
Phone (602) 264-3824

3811 E Bell Rd
Ste 111
Phoenix, AZ 85032
Phone (602) 675-2585

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1366293227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 W ORANGE DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053376",
            "telephone_number": "480-257-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 W ORANGE DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053376",
            "telephone_number": "480-257-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "DIAMOND",
        "middle_name": "MERCEDES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "305575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.