Individual provider Active NPI

Alexandra Carolina Idrovo, MD

  • Pediatric Nephrology Physician
  • Phoenix, AZ
National Provider Identifier
1740620095
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
73613 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1000
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125064135 IL
Pediatric Nephrology Physician 2080P0210X Q9169 TX
Pediatric Nephrology Physician 2080P0210X 73613 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

1900 W Polk St Rm 1134
Chicago, IL 60612-3723
Phone (832) 693-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160815000226 TX Practitioner - Pediatric Medicine 1658677398 Reassigns benefits to 1 organization
I20240905000624 AZ Practitioner - Nephrology 1658677398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

Hospital & facility affiliations

  • Phoenix Children'S Hospital Hospital, Phoenix, AZ, CCN 033302

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125064135ILMDPediatrics Physician
73613AZMDPediatric Nephrology Physician
Q9169TXMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 3, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2024 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Aug 1, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Oct 3, 2022 Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7609 Preston Rd
Plano, TX 75024
Phone (214) 456-2444

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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.

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1740620095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 W Polk St Rm 1134",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "832-693-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDROVO",
        "first_name": "ALEXANDRA",
        "middle_name": "CAROLINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125064135",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "Q9169",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "AZ",
            "license": "73613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.