Individual provider Active NPI

Kristina Deveau, NP-C

  • Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1528511482
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP8871 Issued in AZ
Practice address
13555 W McDowell Rd Ste 101
Goodyear, AZ 85395-2625
Phone
(623) 935-4700
Fax
(623) 935-4707
NPI assigned
Jul 27, 2016
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP8871 AZ Primary

Addresses

Primary practice location

13555 W McDowell Rd Ste 101
Goodyear, AZ 85395-2625

Mailing address

3815 E Bell Rd Ste 4500
Phoenix, AZ 85032-2171
Phone (602) 633-3848

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
I20160831000514 AZ Practitioner - Nurse Practitioner 5799071726 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
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13555 W McDowell Rd
Goodyear, AZ 85395-2625
Phone (623) 512-4390

14415 W McDowell Rd
Suite D102
Goodyear, AZ 85395-2521
Phone (623) 512-4190

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Arizona, LLC CurrentSince Apr 20, 2019 Accepting new patients
Privia Medical Group Arizona, LLC Family Medicine CurrentSince Apr 20, 2019 Accepting new patients
Privia Medical Group Arizona, LLC Family Medicine Current Accepting new patients

Locations

13555 W McDowell Rd
Ste 101
Goodyear, AZ 85395
Phone (623) 935-4700

13555 W McDowell Rd
Ste 103
Goodyear, AZ 85395
Phone (623) 433-0155

14415 W McDowell Rd
Ste D102
Goodyear, AZ 85395
Phone (623) 512-4190

10240 W Indian School Rd
Ste 155
Phoenix, AZ 85037
Phone (623) 385-7900

1301 S 7th Ave
Ste 400
Phoenix, AZ 85007
Phone (602) 824-3358

3815 E Bell Rd
Ste 2200
Phoenix, AZ 85032
Phone (602) 931-4689

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

Interoperability endpoints

  • Direct secure messaging: kristina.deveau.2@33227.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1528511482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322171",
            "telephone_number": "602-633-3848",
            "fax_number": "602-633-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD STE 101",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952625",
            "telephone_number": "623-935-4700",
            "fax_number": "623-935-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVEAU",
        "first_name": "KRISTINA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.