Individual provider Active NPI

Tracey Pugh, NP

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1790401396
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
282573 Issued in AZ
Practice address
1510 E Flower St
Phoenix, AZ 85014-5698
Phone
(602) 954-0444
NPI assigned
Oct 14, 2022
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 282573 AZ Primary

Addresses

Primary practice location

1510 E Flower St
Phoenix, AZ 85014-5698

Mailing address

1510 E Flower St
Phoenix, AZ 85014-5698
Phone (602) 954-0444

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
I20221103000673 AZ Practitioner - Nurse Practitioner 6507233558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians
Geriatric Solutions - Hov LLCGroup PAC ID 1456644780, 20 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

1510 E Flower St
Phoenix, AZ 85014-5656
Phone (602) 954-0444

19636 N 27TH Ave
Suite 201
Phoenix, AZ 85027-4015
Phone (623) 516-4400

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282573AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Solutions - Hov, LLC CurrentSince Oct 24, 2022 Accepting new patients
Honorhealth Ambulatory CurrentSince Feb 1, 2026 Accepting new patients
Honorhealth Ambulatory CurrentSince Feb 1, 2026 Accepting new patients

Locations

1510 E Flower St
Phoenix, AZ 85014
Phone (602) 530-6900

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Interoperability endpoints

  • Direct secure messaging: tracey.pugh.1@32658.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1790401396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 E FLOWER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145698",
            "telephone_number": "602-954-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E FLOWER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145698",
            "telephone_number": "602-954-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "TRACEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2023-10-10",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "282573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.