Maricela Sevilla Olea, FNP-C
Individual provider Active NPI Family Nurse Practitioner · San Luis, AZ
NPI 1447924907 · NPPES record last updated Aug 13, 2024
Key facts
- NPI
- 1447924907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 261918 (AZ)
- Practice address
- 151 S Oak Ave Ste 2
San Luis, AZ 85336-0756 - Phone
- (928) 662-0414
- Fax
- (928) 722-6113
- NPI assigned
- Aug 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Luis Walk-in Clinic Inc
Practice addresses (Care Compare)
1233 N Main St
Suite 1a
San Luis, AZ 85336-0663
Phone (928) 550-5514
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210818003865 | AZ | Practitioner - Nurse Practitioner | 8325443054 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 261918 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Luis Walk-in Clinic, Inc. | Current |
Accepting new patients | |
| San Luis Walk-in Clinic, Inc. | Current |
Accepting new patients | |
| San Luis Walk-in Clinic, Inc. | Current | Accepting new patients |
Locations
1980 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 392-3691
601 W Riverside Dr
Ste 4
Parker, AZ 85344
Phone (928) 256-4110
950 E Main St
Bldg B
Somerton, AZ 85350
Phone (928) 236-8001
214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 261918 | AZ | Yes |
Addresses
Primary practice location
151 S Oak Ave Ste 2
San Luis, AZ 85336-0756
Mailing address
PO Box 617
Somerton, AZ 85350-0617
Phone (928) 315-7910
Other practice location 1
950 E Main St Bldg B
Somerton, AZ 85350-7409
Phone (928) 236-8001
Other providers in San Luis, AZ
- Larry Anthony Morales
- Siyanda Obed Mquqwana
- Clarisse Vanessa Ngueha-Nana
- Armik Ohanesyan Salmas
- Alejandro Olea
- Angeles Olivarez
- Melissa Ortega
- Omara Hanid Ortiz
- Patricia Rodriguez, FNP-C & Associates
- Jason Cyril Patron
All providers in San Luis, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.