Active NPI
Julia Nieto, PA-C
- Physician Assistant
- Tempe, AZ
National Provider Identifier
1669920732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6451
- Practice address
- 1315 W Southern Ave
Tempe, AZ 85282 - Phone
- (602) 569-3999
- Fax
- (602) 569-3887
- NPI assigned
- Sep 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6451 | AZ | Primary |
Addresses
Primary practice location
1315 W Southern Ave
Tempe, AZ 85282
Mailing address
1533 E Willetta St
Phoenix, AZ 85006-2935
Phone (602) 569-3999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 194468 | Medicaid | AZ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1315 W Southern Ave
Tempe, AZ 85282-4519
Phone (602) 569-3999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Kidney Associates PLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1780668921
-
- Nephrology Physician
- Mesa, AZ
- NPI 1144372905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566518400000",
"number": "1669920732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1533 E WILLETTA ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062935",
"telephone_number": "602-569-3999",
"fax_number": "602-569-3887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 W SOUTHERN AVE",
"city": "TEMPE",
"state": "AZ",
"postal_code": "85282",
"telephone_number": "602-569-3999",
"fax_number": "602-569-3887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIETO",
"first_name": "JULIA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2019-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "6451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "194468",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.