Individual provider Active NPI

Ampili Umayamma, NP

  • Gerontology Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1467901769
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP8856 Issued in AZ
Practice address
5252 E Main St
Mesa, AZ 85205-8022
Phone
(480) 396-3222
Fax
(480) 396-2298
NPI assigned
Sep 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP8856 AZ Primary

Addresses

Primary practice location

5252 E Main St
Mesa, AZ 85205-8022

Mailing address

105 S Delaware Dr
Ste 1
Apache Junction, AZ 85120-6512
Phone (480) 396-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161123000032 AZ Practitioner - Nurse Practitioner 4486933058 Reassigns benefits to 1 organization
I20230515000378 TX Practitioner - Nurse Practitioner 4486933058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Practice addresses (Care Compare)

483 W Seed Farm Rd
Hu Hu Kam Memorial Hosp
Sacaton, AZ 85147-0038
Phone (602) 528-1200

Hospital & facility affiliations

  • Huhu Kam Memorial Hospital Hospital, Sacaton, AZ, CCN 031308

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care Corporation CurrentSince Apr 13, 2023 Accepting new patients
Gila River Health Care CurrentSince Apr 13, 2023 Accepting new patients

Locations

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1467901769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S DELAWARE DR",
            "address_2": "STE 1",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206512",
            "telephone_number": "480-396-3222",
            "fax_number": "480-396-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058022",
            "telephone_number": "480-396-3222",
            "fax_number": "480-396-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMAYAMMA",
        "first_name": "AMPILI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP8856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.