Kaacha Star Naminda, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

255370 Issued in AZ

Practice address

7750 E Broadway Blvd Ste A100
Tucson, AZ 85710-3901

Phone

(520) 327-1529

NPI assigned

Jan 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1548781487
  NPD
• Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Thatcher, AZ
  • NPI 1053828160
  NPD (past)
• Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Yuma, AZ
  • NPI 1427554708
  NPD (past)
• Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Casa Grande, AZ
  • NPI 1528400538
  NPD (past)
• Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1932530797
  NPD (past)

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1679161889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 E BROADWAY BLVD STE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103901",
            "telephone_number": "520-327-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 E BROADWAY BLVD STE A100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103901",
            "telephone_number": "520-327-1529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 E Florence Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851224228",
            "country_code": "US",
            "telephone_number": "520-723-4429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "709 N Allred Ln Suites 104-105",
            "address_purpose": "LOCATION",
            "city": "Thatcher",
            "state": "AZ",
            "postal_code": "85552",
            "country_code": "US",
            "telephone_number": "928-362-7343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5120 E Alberta Dr",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857113119",
            "country_code": "US",
            "telephone_number": "520-514-7480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856351857",
            "country_code": "US",
            "telephone_number": "520-452-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7756 E Broadway Blvd Ste C100",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857104022",
            "country_code": "US",
            "telephone_number": "520-327-1529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3860 W 24th St Ste 201-208",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853649282",
            "country_code": "US",
            "telephone_number": "928-276-9225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 S Meyer Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857012207",
            "country_code": "US",
            "telephone_number": "520-209-2492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAMINDA",
        "first_name": "KAACHA",
        "middle_name": "STAR",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2023-11-06",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1023876",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "255370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Naldo, RD
• Aparna Nallagangula
• Matthew Paul Namanny, DO
• Ali Namazifard, PHARM D
• Shaida Namazifard, PHARM.D.
• Nancy Lynne Namka, ED. D.
• Bernard Nanadiego
• James Martin Nance, KINESIOTHERAPIST
• Orville C Nance
• Nancy E Campbell, LLC

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.