Individual provider Active NPI

Cynthia Joann Hermosillo, FNP-C, APRN

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1619612645
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
279889 Issued in AZ
Practice address
3744 S Rome St
Gilbert, AZ 85297-7350
Phone
(480) 224-9500
NPI assigned
May 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN217169 AZ
Family Nurse Practitioner 363LF0000X 279889 AZ Primary

Addresses

Primary practice location

3744 S Rome St
Gilbert, AZ 85297-7350

Mailing address

1124 E San Carlos Way
Chandler, AZ 85249-4712
Phone (480) 299-3761

Other names 1

  • Ms. Cynthia Joann Lopez Professional name

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
I20230714000659 AZ Practitioner - Nurse Practitioner 7618337239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Internal Medicine PLLCGroup PAC ID 7315251964, 24 clinicians

Practice addresses (Care Compare)

5755 E Main St
Mesa, AZ 85205-8814
Phone (480) 214-2400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hermosillo Health LLC CurrentSince Jun 4, 2023 Accepting new patients
Allied Internal Medicine PLLC CurrentSince Jul 1, 2023 Accepting new patients
Red Mountain Healthcare LLC Past Accepting new patients
Thompson Peak Healthcare LLC Past Accepting new patients

Locations

2012 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 938-0700

3744 S Rome St
Gilbert, AZ 85297
Phone (480) 224-9500

5755 E Main St
Mesa, AZ 85205
Phone (480) 214-2400

215 S Power Rd
Mesa, AZ 85206
Phone (480) 945-7711

60 S 58th St
Mesa, AZ 85206
Phone (480) 832-3903

2525 W Beryl Ave
Phoenix, AZ 85021
Phone (602) 424-7967

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 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": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1619612645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E SAN CARLOS WAY",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852494712",
            "telephone_number": "480-299-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 S ROME ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977350",
            "telephone_number": "480-224-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMOSILLO",
        "first_name": "CYNTHIA",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN217169",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "LOPEZ",
            "middle_name": "JOANN",
            "prefix": "MS.",
            "credential": "FNP, APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.