Individual provider Active NPI

Susan G Hawrylkiw, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1457427445
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP1704 Issued in AZ
Practice address
4530 E Muirwood Dr
St 11
Phoenix, AZ 85048-7639
Phone
(480) 961-2365
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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 AP1704 AZ Primary

Addresses

Primary practice location

4530 E Muirwood Dr
St 11
Phoenix, AZ 85048-7639

Mailing address

4530 E Muirwood Dr
Ste 111
Phoenix, AZ 85048-7693
Phone (480) 961-2365

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
I20260414002174 AZ Practitioner - Nurse Practitioner 1254620552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Neurology P CGroup PAC ID 6507757234, 24 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 111
Phoenix, AZ 85048-7693
Phone (480) 961-2365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP1704AZMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: susan.hawrylkiw.1@8409.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1457427445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-961-2365",
            "fax_number": "480-272-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "ST 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487639",
            "telephone_number": "480-961-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWRYLKIW",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.