Individual provider Active NPI

Aizelle Martinez, AGPCNP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1821707001
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
283198 Issued in AZ
Practice address
350 W Thomas Rd
Phoenix, AZ 85013-4496
Phone
(602) 406-3000
NPI assigned
Nov 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 283198 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
Phoenix, AZ 85013-4496

Mailing address

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-6313

Other names 1

  • Aizelle Bautista Former name

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
I20230206002815 AZ Practitioner - Nurse Practitioner 7113399825 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
St. Joseph'S Outpatient Surgery Center, LLC Current Accepting new patients
Sjhmc Physician Services CurrentSince Aug 11, 2023 Accepting new patients
St Josephs Pathology Current Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

240 W Thomas Rd
#301
Phoenix, AZ 85013
Phone (602) 406-6262

File 56765
Los Angeles, CA 90074

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1821707001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134496",
            "telephone_number": "602-406-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AIZELLE",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "283198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIZELLE",
            "last_name": "BAUTISTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.