Individual provider Active NPI

Ilynn Gruss, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Marana, AZ
National Provider Identifier
1669215729
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
307653 Issued in AZ
Practice address
13395 N Marana Main St
Marana, AZ 85653-7008
Phone
(520) 682-4111
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 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 307653 AZ Primary

Addresses

Primary practice location

13395 N Marana Main St
Marana, AZ 85653-7008

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

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
I20240702000463 AZ Practitioner - Nurse Practitioner 3678017688 Reassigns benefits to 1 organization

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
Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

13395 N Marana Main St
Marana, AZ 85653-7008
Phone (520) 682-4111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307653AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center, Inc Past Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: llynn.gruss.1@32652.direct.athenahealth.com

Organizations & group practices 3

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1669215729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSS",
        "first_name": "ILYNN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "307653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marana, AZ

Sources for this page

Verify at the official NPI Registry.