Individual provider Active NPI

Stephanie L Lesser, NP

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1376892141
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP4599 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-3277
Fax
(602) 933-4326
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN146373 AZ
Pediatric Nurse Practitioner 363LP0200X AP4599 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2702 North 3Rd Street
4020
Phoenix, AZ 85004-4608
Phone (602) 323-3407

Other identifiers 1

IdentifierTypeStateIssuer
749960MedicaidAZ

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
I20121207000326 AZ Practitioner - Nurse Practitioner 1759533243 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Nov 1, 2018 Accepting new patients
Phoenix Children'S Hospital Current Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients
Mountain Park Health Center Past Accepting new patients
Mountain Park Health Center Past Accepting new patients

Locations

6524 W Sack Dr
Ste 130
Glendale, AZ 85308

6524 W Sack Dr
Glendale, AZ 85308

2045 S Vineyard
Ste 137
Mesa, AZ 85210

1920 E Cambridge Ave
Ste 200
Phoenix, AZ 85006
Phone (602) 933-0965

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1920 E Cambridge Ave
Ste 201
Phoenix, AZ 85006
Phone (602) 254-5561

Organizations & group practices 5

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": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1376892141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NORTH 3RD STREET",
            "address_2": "4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044608",
            "telephone_number": "602-323-3407",
            "fax_number": "602-323-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3277",
            "fax_number": "602-933-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSER",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RN146373",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP4599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "749960",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.