Individual provider Active NPI

Mary Joann Streetman, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1619917945
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23737 Issued in AZ
Practice address
650 East Indian School Rd
Phoenix, AZ 85012
Phone
(602) 277-5551
Fax
(602) 222-6513
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 23737 AZ Primary

Addresses

Primary practice location

650 East Indian School Rd
Phoenix, AZ 85012

Mailing address

PO Box 696
Laveen, AZ 85339-0696
Phone (602) 277-5551

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
I20141008000442 AZ Order and Referring Only - Family PracticePractitioner - Family Practice 2860672250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23737AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619917945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853390696",
            "telephone_number": "602-277-5551",
            "fax_number": "602-222-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EAST INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85012",
            "telephone_number": "602-277-5551",
            "fax_number": "602-222-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETMAN",
        "first_name": "MARY",
        "middle_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.