Individual provider Active NPI

Heather A Trujillo-Olkkonen, P.A.

  • Medical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1700864071
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5925 Issued in AZ
Practice address
3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290
Phone
(480) 345-1980
Fax
(480) 926-1721
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 7057360001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7047150001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7209350001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 70349500001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7046960001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7939960001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 704516001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 8220410001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7629170001 AZ
Medical Physician Assistant 363AM0700X 5925 AZ Primary

Addresses

Primary practice location

3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290

Mailing address

1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287

Other practice location 1

2919 S Ellsworth Rd Ste 111
Mesa, AZ 85212-2165
Phone (480) 564-1185

Other practice location 2

3011 S Lindsay Rd Ste 101
Gilbert, AZ 85295-4333
Phone (480) 726-2500

Other practice location 3

15256 N 75th Ave Ste 360
Peoria, AZ 85381-4761
Phone (623) 486-2424

Other practice location 4

1277 E Missouri Ave Ste 101
Phoenix, AZ 85014-2916
Phone (602) 296-4060

Other practice location 5

270 E Hunt Hwy Ste A-2
San Tan Valley, AZ 85143-4962
Phone (480) 882-2222

Other practice location 6

14239 W Bell Rd Ste 108
Surprise, AZ 85374-2470
Phone (623) 248-4283

Other practice location 7

2145 E Warner Rd Ste 104
Tempe, AZ 85284-3549
Phone (480) 664-9443

Other practice location 8

20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282
Phone (480) 563-1144

Other identifiers 1

IdentifierTypeStateIssuer
974750MedicaidAZ

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
I20150527002023 AZ Practitioner - Physician Assistant 0547446155 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

1683 E Florence Blvd
Suite 7
Casa Grande, AZ 85122-4813
Phone (520) 876-0800

20236 N John Wayne Pkwy
Suite 100
Maricopa, AZ 85139-2911
Phone (520) 518-7510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
70349500001AZMDIntellectual and/or Developmental Disabilities Residential Treatment Facility
704516001AZMDDurable Medical Equipment & Medical Supplies
7046960001AZMDDurable Medical Equipment & Medical Supplies
7047150001AZMDDurable Medical Equipment & Medical Supplies
7057360001AZMDDurable Medical Equipment & Medical Supplies
7209350001AZMDDurable Medical Equipment & Medical Supplies
7629170001AZMDDurable Medical Equipment & Medical Supplies
7939960001AZMDDurable Medical Equipment & Medical Supplies
8220410001AZMDDurable Medical Equipment & Medical Supplies
5925AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michael T Reilly MD & David H Gilbert MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: heather.trujilloolkkonenpac.p1@direct.nextcare.nextgenshare.com

Organizations & group practices 12

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1700864071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-503-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047290",
            "telephone_number": "480-345-1980",
            "fax_number": "480-926-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 S Ellsworth Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122165",
            "country_code": "US",
            "telephone_number": "480-564-1185",
            "fax_number": "480-590-4375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 S Lindsay Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-726-2500",
            "fax_number": "480-726-2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15256 N 75th Ave Ste 360",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814761",
            "country_code": "US",
            "telephone_number": "623-486-2424",
            "fax_number": "623-486-4324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1277 E Missouri Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850142916",
            "country_code": "US",
            "telephone_number": "602-296-4060",
            "fax_number": "602-296-4146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270 E Hunt Hwy Ste A-2",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851434962",
            "country_code": "US",
            "telephone_number": "480-882-2222",
            "fax_number": "480-882-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14239 W Bell Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853742470",
            "country_code": "US",
            "telephone_number": "623-248-4283",
            "fax_number": "623-440-4255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2145 E Warner Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843549",
            "country_code": "US",
            "telephone_number": "480-664-9443",
            "fax_number": "480-664-9378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20860 N Tatum Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504282",
            "country_code": "US",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO-OLKKONEN",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7057360001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7047150001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7209350001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "70349500001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7046960001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7939960001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "704516001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "8220410001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7629170001",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "974750",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.