Individual provider Active NPI

Jesus J Justiniano, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1649095795
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
236829 Issued in AZ
Practice address
6710 E University Dr Unit 164
Mesa, AZ 85205-7660
Phone
(480) 709-3375
NPI assigned
Nov 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 236829 AZ Primary

Addresses

Primary practice location

6710 E University Dr Unit 164
Mesa, AZ 85205-7660

Mailing address

6710 E University Dr Unit 164
Mesa, AZ 85205-7660
Phone (480) 709-3375

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
I20241218001632 AZ Practitioner - Nurse Practitioner 8325575152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians
Banner Urgent Care Arizona LLCGroup PAC ID 3678749496, 47 clinicians

Practice addresses (Care Compare)

10330 N Scottsdale Rd
Suite 25
Scottsdale, AZ 85253-1427
Phone (602) 255-7625

1215 S Higley Rd
Mesa, AZ 85206-3486
Phone (480) 827-5740

1660 N Higley Rd
Suite 104
Gilbert, AZ 85234-1615
Phone (480) 827-5600

1676 E McMurray Blvd
Suite 1
Casa Grande, AZ 85122-4798
Phone (520) 316-0688

1908 E McKellips Rd
Mesa, AZ 85203-2866
Phone (480) 827-5610

1955 W Guadalupe Rd
Suite 101 102
Mesa, AZ 85202-7487
Phone (480) 827-5620

2950 S Alma School Rd
Suite 1
Chandler, AZ 85286-8120
Phone (480) 827-5690

3141 S McClintock Dr
Suite 1
Tempe, AZ 85282-5682
Phone (480) 827-5650

3160 E Queen Creek Rd
Gilbert, AZ 85297-8403
Phone (480) 827-5790

35945 N Gary Rd
San Tan Valley, AZ 85143-5748
Phone (480) 827-5750

40773 N Ironwood Dr
San Tan Valley, AZ 85140-7002
Phone (480) 827-5760

4206 E Chandler Blvd
Suite 100
Phoenix, AZ 85048-8873
Phone (480) 827-5590

4232 W Bell Rd
Glendale, AZ 85308-4027
Phone (623) 465-6360

641 W Warner Rd
Gilbert, AZ 85233-7266
Phone (480) 827-5680

931 E Elliot Rd
Suite 115
Tempe, AZ 85284-1583
Phone (480) 827-5640

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Services, LLC Current Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Feb 1, 2025 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Feb 1, 2025 Accepting new patients
Banner Urgent Care Arizona LLC CurrentSince Feb 1, 2025 Accepting new patients
Banner Urgent Care Arizona LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

2950 S Alma School Rd
Ste 1
Chandler, AZ 85286
Phone (480) 821-2028

3126 S Higley Rd
Ste 109
Gilbert, AZ 85295
Phone (480) 436-8102

3457 W White Mountain Blvd
Lakeside, AZ 85929
Phone (888) 264-2127

1955 W Guadalupe Rd
Ste 1
Mesa, AZ 85202
Phone (480) 207-2990

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

1157 S Crismon Rd
Ste 101
Mesa, AZ 85208
Phone (480) 827-5730

1908 E McKellips Rd
Mesa, AZ 85203
Phone (480) 827-5610

101 E State Highway 260
Ste G
Payson, AZ 85541
Phone (888) 264-2127

4760 E Thunderbird Rd
Ste 1
Phoenix, AZ 85032
Phone (480) 827-5590

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

10330 N Scottsdale Rd
Ste 25
Scottsdale, AZ 85253
Phone (602) 255-7625

680 E Deuce of Clubs
Ste B
Show Low, AZ 85901
Phone (928) 537-2777

7066 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 514-0344

Organizations & group practices 6

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": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1649095795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 E UNIVERSITY DR UNIT 164",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057660",
            "telephone_number": "480-709-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 E UNIVERSITY DR UNIT 164",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057660",
            "telephone_number": "480-709-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANO",
        "first_name": "JESUS",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "236829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.