Individual provider Active NPI

Christine Ndunge Nikolic, NP-C

  • Adult Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1760482574
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP1691 Issued in AZ
Practice address
6309 E Baywood Ave Ste 101
Mesa, AZ 85206-1726
Phone
(480) 641-5400
Fax
(480) 218-4353
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 RN121750 AZ
Adult Health Nurse Practitioner 363LA2200X AP1691 AZ Primary

Addresses

Primary practice location

6309 E Baywood Ave Ste 101
Mesa, AZ 85206-1726

Mailing address

6309 E Baywood Ave Ste 101
Mesa, AZ 85206-1726
Phone (480) 641-5400

Other identifiers 4

IdentifierTypeStateIssuer
P00150020OtherAZRAILROAD MEDICARE
P00418321OtherAZRAILROAD MEDICARE
WCSKQOtherAZSUN HEALTH GROUP #
836356MedicaidAZ

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
I20040429000915 AZ Practitioner - Nurse Practitioner 5496742587 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Associates of Mesa PC CurrentSince Jan 11, 2010 Accepting new patients
Cardiovascular Associates of Mesa P C CurrentSince Jan 11, 2010 Accepting new patients

Locations

2979 W Elliot Rd
Ste 112
Chandler, AZ 85224

3513 S Mercy Rd
Gilbert, AZ 85297
Phone (420) 641-5400

2730 S Val Vista Dr
Ste 140
Gilbert, AZ 85295
Phone (480) 277-0043

6116 E Arbor Ave
Ste 112
Mesa, AZ 85206

6309 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone 48064154004010

37100 N Gantzel Rd
Ste 202
San Tan Valley, AZ 85140
Phone (480) 394-4469

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1760482574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 E BAYWOOD AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061726",
            "telephone_number": "480-641-5400",
            "fax_number": "480-218-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 E BAYWOOD AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061726",
            "telephone_number": "480-641-5400",
            "fax_number": "480-218-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLIC",
        "first_name": "CHRISTINE",
        "middle_name": "NDUNGE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN121750",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP1691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00150020",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00418321",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUN HEALTH GROUP #",
            "identifier": "WCSKQ",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "836356",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.