Individual provider Active NPI

Jacqueline McLeod, FNP-C

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1740935501
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
273257 Issued in AZ
Practice address
13555 W McDowell Rd Ste 209
Goodyear, AZ 85395-2628
Phone
(623) 512-4199
NPI assigned
Feb 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 273257 AZ Primary

Addresses

Primary practice location

13555 W McDowell Rd Ste 209
Goodyear, AZ 85395-2628

Mailing address

4611 E Morning Vista LN
Cave Creek, AZ 85331-3251
Phone (586) 212-5644

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
I20220601002030 AZ Practitioner - Nurse Practitioner 7315325495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Desert Ear Nose and Throat Specialist PLLCGroup PAC ID 5890105530, 7 clinicians

Practice addresses (Care Compare)

2111 E Highland Ave
Suite 431B
Phoenix, AZ 85016-4735
Phone (623) 512-4162

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Desert Ear Nose & Throat Specialist, PLLC CurrentSince Mar 31, 2022 Accepting new patients

Locations

1355 N Litchfield Rd
Ste 135
Goodyear, AZ 85395
Phone (623) 512-4199

1355 N Litchfield Rd
Goodyear, AZ 85395
Phone (623) 848-5700

13555 W McDowell Rd
Ste 209
Goodyear, AZ 85395
Phone (623) 512-4162

2111 E Highland Ave
Ste 431B
Phoenix, AZ 85016
Phone (623) 512-4162

Interoperability endpoints

  • Direct secure messaging: jmcleod@azdesertent.emadirect.md

Organizations & group practices 1

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": "1645228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1740935501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 E MORNING VISTA LN",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853313251",
            "telephone_number": "586-212-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD STE 209",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952628",
            "telephone_number": "623-512-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "JACQUELINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-19",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "273257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.