Individual provider Active NPI

Mariley M Segrera-Grabania

  • Research Study Specialist
  • Mesa, AZ
National Provider Identifier
1386421063
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Study SpecialistTaxonomy code 1744R1102X
Practice address
3048 E Baseline Rd Ste 122
Mesa, AZ 85204-7288
Phone
(480) 497-5933
Fax
(480) 497-5934
NPI assigned
Sep 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Research Study Specialist 1744R1102X Primary

Addresses

Primary practice location

3048 E Baseline Rd Ste 122
Mesa, AZ 85204-7288

Mailing address

PO Box 838
Gilbert, AZ 85299-0838
Phone (480) 497-5933

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Vida Medical LLC CurrentSince Nov 3, 2024 Accepting new patients
Hope Diabetes Center, LLC CurrentSince Sep 17, 2023 Accepting new patients

Locations

3048 E Baseline Rd
Ste 122
Mesa, AZ 85204
Phone (480) 497-5933

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": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1386421063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 838",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852990838",
            "telephone_number": "480-497-5933",
            "fax_number": "480-497-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD STE 122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047288",
            "telephone_number": "480-497-5933",
            "fax_number": "480-497-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRERA-GRABANIA",
        "first_name": "MARILEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.