Individual provider Active NPI

Natividad Verdejo, MD

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1396890612
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22684 Issued in AZ
Practice address
2360 W Ray Rd Ste 2
Chandler, AZ 85224-3516
Phone
(480) 855-3770
Fax
(480) 855-7906
NPI assigned
Jan 25, 2007
Last updated
Jul 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22684 AZ Primary

Addresses

Primary practice location

2360 W Ray Rd Ste 2
Chandler, AZ 85224-3516

Mailing address

PO Box 6218
Chandler, AZ 85246-6218
Phone (480) 855-3770

Other identifiers 1

IdentifierTypeStateIssuer
187395MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102001046 AZ Practitioner - Family Practice 0648298299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Puerto Rico School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2360 W Ray Rd
Suite 2
Chandler, AZ 85224-3634
Phone (480) 855-3770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22684AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Family Medicine, Inc. Family Medicine CurrentSince Mar 1, 2010 Accepting new patients

Locations

2360 W Ray Rd
Ste 2
Chandler, AZ 85224
Phone (480) 855-3770

637 E Main St
Mesa, AZ 85203
Phone (480) 272-8877

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1396890612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6218",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466218",
            "telephone_number": "480-855-3770",
            "fax_number": "480-855-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 W RAY RD STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243516",
            "telephone_number": "480-855-3770",
            "fax_number": "480-855-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDEJO",
        "first_name": "NATIVIDAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "22684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187395",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.