Individual provider Active NPI

Bryan E Ratajski, FNP-C

  • Family Nurse Practitioner
  • San Tan Valley, AZ
National Provider Identifier
1821874629
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
297289 Issued in AZ
Practice address
287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096
Phone
(480) 677-8282
Fax
(888) 316-1686
NPI assigned
Sep 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 297289 AZ Primary

Addresses

Primary practice location

287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 677-8282

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
I20231002001290 AZ Practitioner - Nurse Practitioner 4981058492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince Sep 18, 2023 Accepting new patients
Good Health Medical, PLLC CurrentSince Sep 18, 2023 Accepting new patients
Good Health Medical, PLLC Current Accepting new patients
Livn, P.C. Past Accepting new patients

Locations

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1821874629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 E HUNT HWY STE 105",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435096",
            "telephone_number": "480-677-8282",
            "fax_number": "888-316-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATAJSKI",
        "first_name": "BRYAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "297289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

Verify at the official NPI Registry.