Individual provider Active NPI

Leslie A Johnson, F.N.P.

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1740255181
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP 1352 Issued in AZ
Practice address
19636 N 27TH Ave
Ste 401
Phoenix, AZ 85027-4013
Phone
(602) 298-8888
Fax
(602) 978-4129
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN091028 AZ
Family Nurse Practitioner 363LF0000X AP 1352 AZ Primary

Addresses

Primary practice location

19636 N 27TH Ave
Ste 401
Phoenix, AZ 85027-4013

Mailing address

P.O. Box 29870
Phoenix, AZ 85038-9870
Phone (602) 772-3800

Other identifiers 2

IdentifierTypeStateIssuer
796617MedicaidAZ
3Z3967OtherAZHEALTHNET

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
I20100526000200 AZ Practitioner - Nurse Practitioner 7214066455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

5555 W Thunderbird Rd
Banner Health Clinic
Glendale, AZ 85306-4622
Phone (602) 865-5555

5601 W Eugie Ave
Suite 100
Glendale, AZ 85304-1256
Phone (602) 865-4510

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN091028AZMDRegistered Nurse
AP 1352AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC Current Accepting new patients

Locations

5757 W Thunderbird Rd
Ste E151
Glendale, AZ 85306
Phone (602) 843-3811

18699 N 67th Ave
Ste 120
Glendale, AZ 85308
Phone (602) 298-8888

7701 W Aspera Blvd
Ste 102
Glendale, AZ 85308
Phone (623) 248-2100

5601 W Eugie Ave
Ste 100
Glendale, AZ 85304
Phone (602) 865-4510

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

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

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

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1740255181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 29870",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389870",
            "telephone_number": "602-772-3800",
            "fax_number": "602-772-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE",
            "address_2": "STE 401",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274013",
            "telephone_number": "602-298-8888",
            "fax_number": "602-978-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN091028",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP 1352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "796617",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3967",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.