Individual provider Active NPI

Marla Jana Yazzie, M.D.

  • Pediatrics Physician
  • Fort Defiance, AZ
National Provider Identifier
1679830764
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
50693 Issued in AZ
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Phone
(928) 729-8000
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 50693 AZ Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649

Other practice location 1

483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Phone (602) 528-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151007001907 TX Practitioner - Pediatric Medicine 3476861691 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care CurrentSince Oct 21, 2024 Accepting new patients
Gila River Health Care Corporation CurrentSince Oct 21, 2024 Accepting new patients
DHHS, PHS, Naihs, Gallup Indian Medical Center CurrentSince Jan 10, 2018 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jan 10, 2018 Accepting new patients

Locations

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Interoperability endpoints

  • Direct secure messaging: marla.yazzie.p1@direct.nachci.nextgenshare.com

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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1679830764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "483 W Seed Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Sacaton",
            "state": "AZ",
            "postal_code": "851475000",
            "country_code": "US",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZZIE",
        "first_name": "MARLA",
        "middle_name": "JANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.