Individual provider Active NPI

Nicholas Smith, APRN

  • Acute Care Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1679200158
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
00000 Issued in AZ
Practice address
1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone
(480) 543-2000
NPI assigned
Aug 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 00000 AZ Primary

Addresses

Primary practice location

1900 N Higley Rd
Gilbert, AZ 85234-1604

Mailing address

19692 E Walnut Rd
Queen Creek, AZ 85142-7874
Phone (480) 371-9641

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
I20220829000507 AZ Practitioner - Nurse Practitioner 8921482738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians
Toca at Banner Health LLCGroup PAC ID 3072934777, 26 clinicians

Practice addresses (Care Compare)

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

9377 E Bell Rd
Suite 231
Scottsdale, AZ 85260-1503
Phone (602) 277-6211

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
60.29
Promoting interoperability
98
Improvement activities
40
Cost
71.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toca at Banner Health LLC CurrentSince Jul 18, 2023 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2022 Accepting new patients
Toca at Banner Health LLC CurrentSince Jul 18, 2023 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

1125 S Alma School Rd
Ste 210
Chandler, AZ 85286
Phone (480) 256-4900

1920 N Higley Rd
Ste 206
Gilbert, AZ 85234
Phone (480) 543-6700

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

18700 N 64th Dr
Ste 220
Glendale, AZ 85308

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

2222 E Highland Ave
Ste 300
Phoenix, AZ 85016
Phone (602) 483-6165

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

9377 E Bell Rd
Ste 231
Scottsdale, AZ 85260
Phone (602) 313-1549

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

5002 S Mill Ave
Tempe, AZ 85282
Phone (602) 512-8607

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1679200158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19692 E WALNUT RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427874",
            "telephone_number": "480-371-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341604",
            "telephone_number": "480-543-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.