Individual provider Active NPI

Adriana Jazmin Medeiros, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1467099143
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
236622 Issued in AZ
Practice address
1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone
(520) 694-0111
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 236622 AZ Primary

Addresses

Primary practice location

1625 N Campbell Ave
Tucson, AZ 85719-4330

Mailing address

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Adriana.medeiros@bannerhealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200212002210 AZ Practitioner - Nurse Practitioner 5597191445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236622AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Mar 1, 2020 Accepting new patients
Banner-University Medical Group CurrentSince Mar 1, 2020 Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

Interoperability endpoints

  • Direct secure messaging: adriana.medeiros@bannerhealth.com

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": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1467099143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "ADRIANA",
        "middle_name": "JAZMIN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "236622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Adriana.medeiros@bannerhealth.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1625 N Campbell Ave",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857194330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.