Individual provider Active NPI

Jasma M Dydell, APRN, FNP-BC, CPN

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1639623812
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
242949 Issued in AZ
Practice address
1459 S Higley Rd Ste 106
Gilbert, AZ 85296-5047
Phone
(480) 556-0446
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 77337 KS
Family Nurse Practitioner 363LF0000X 2016028863 MO
Family Nurse Practitioner 363LF0000X 242949 AZ Primary

Addresses

Primary practice location

1459 S Higley Rd Ste 106
Gilbert, AZ 85296-5047

Mailing address

1459 S Higley Rd Ste 106
Gilbert, AZ 85296-5047
Phone (480) 556-0446

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
I20210701001857 AZ Practitioner - Nurse Practitioner 6305132069 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242949AZMDFamily Nurse Practitioner
77337KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aleracare Aic LLC CurrentSince Apr 1, 2024 Accepting new patients
Richard Lee Averitte Jr PLLC CurrentSince Jun 28, 2021 Accepting new patients
Bethesda Pediatrics of Queen Creek Past Accepting new patients
Coolidge Pediatrics Past Accepting new patients

Locations

312 N Alma School Rd
Ste 3
Chandler, AZ 85224

930 N Switzer Canyon Dr
Ste 201
Flagstaff, AZ 86001
Phone (520) 542-2125

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

3555 Western Ave
Kingman, AZ 86409
Phone (928) 530-5430

5350 E High St
Ste 300
Phoenix, AZ 85054
Phone (480) 716-5820

3100 N Navajo Dr
Ste B3
Prescott Valley, AZ 86314
Phone (480) 716-3476

20185 E Ocotillo Rd
Ste 105
Queen Creek, AZ 85142
Phone (480) 677-3600

20401 N 73rd St
Ste 230
Scottsdale, AZ 85255

2120 W Ina Rd
Ste 100
Tucson, AZ 85741
Phone (520) 395-0471

2110 W 24th St
Ste A
Yuma, AZ 85364
Phone (855) 442-7700

Interoperability endpoints

  • Direct secure messaging: jdydell@affderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1639623812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 S HIGLEY RD STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852965047",
            "telephone_number": "480-556-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 S HIGLEY RD STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852965047",
            "telephone_number": "480-556-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYDELL",
        "first_name": "JASMA",
        "middle_name": "M",
        "credential": "APRN, FNP-BC, CPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "77337",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016028863",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "242949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.