Individual provider Active NPI

Jessica Regnaert, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1598077372
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R71959 Issued in AZ
Practice address
2927 N 7TH Ave
St. Joseph'S Family Medicine Center
Phoenix, AZ 85013-4102
Phone
(602) 406-3153
Fax
(602) 406-7176
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R71959 AZ Primary

Addresses

Primary practice location

2927 N 7TH Ave
St. Joseph'S Family Medicine Center
Phoenix, AZ 85013-4102

Mailing address

1917 South Crismon Road
Mesa, AZ 85208
Phone (480) 610-7100

Other identifiers 1

IdentifierTypeStateIssuer
R71959OtherAZTRAINING PERMIT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000218 AZ Practitioner - Family Practice 1355584038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (480) 610-7100

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R71959AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

1459 S Higley Rd
Ste 106
Gilbert, AZ 85296
Phone (480) 543-6780

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 4

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 4

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1598077372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 SOUTH CRISMON ROAD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85208",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "address_2": "ST. JOSEPH'S FAMILY MEDICINE CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGNAERT",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R71959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R71959",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.