Individual provider Active NPI

Eugenia Ursan, DNP

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1699025668
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP4661 Issued in AZ
Practice address
4619 N 24TH St
Phoenix, AZ 85016-5203
Phone
(602) 956-0111
Fax
(602) 956-6789
NPI assigned
Sep 17, 2012
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AP4661 AZ Primary

Addresses

Primary practice location

4619 N 24TH St
Phoenix, AZ 85016-5203

Mailing address

4619 N 24TH St
Phoenix, AZ 85016-5203
Phone (602) 956-0111

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
I20121115000073 AZ Practitioner - Nurse Practitioner 5092966317 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DWF Chiro Care LLCGroup PAC ID 2860628328, 3 clinicians
Cas Medical Center, LLCGroup PAC ID 3870990732, 2 clinicians

Practice addresses (Care Compare)

15396 N 83Rd Ave
Suite C101
Peoria, AZ 85381-5627
Phone (623) 889-7398

4619 N 24TH St
Phoenix, AZ 85016-5203
Phone (602) 956-0111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cas Chiropractic Center PC CurrentSince Jul 1, 2020 Accepting new patients
Sheitelman Medical PLC CurrentSince May 26, 2015 Accepting new patients
Cas Medical Center, LLC CurrentSince May 12, 2021 Accepting new patients
Sheitelman Chiropractic Inc Past Accepting new patients
American Family Chiropractic & Rehab at Desert Ridge, LLC PastSince Mar 1, 2012 Accepting new patients
Afc Physical Medicine of Desert Ridge,PLLC Past Accepting new patients

Locations

4619 N 24th St
Phoenix, AZ 85016
Phone (602) 956-0111

13757 W Bell Rd
Ste 101
Surprise, AZ 85374
Phone (623) 214-7600

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1699025668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165203",
            "telephone_number": "602-956-0111",
            "fax_number": "602-956-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165203",
            "telephone_number": "602-956-0111",
            "fax_number": "602-956-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URSAN",
        "first_name": "EUGENIA",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AP4661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.