Individual provider Active NPI

Vincent M. Noriega, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1831469733
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4338 Issued in AZ
Practice address
2919 S Ellsworth Rd Ste 102
Mesa, AZ 85212-2165
Phone
(480) 354-2008
Fax
(480) 907-1322
NPI assigned
Jan 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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 AP4338 AZ Primary

Addresses

Primary practice location

2919 S Ellsworth Rd Ste 102
Mesa, AZ 85212-2165

Mailing address

2919 S Ellsworth Rd Ste 102
Mesa, AZ 85212-2165
Phone (480) 354-2008

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
I20121009000387 AZ Practitioner - Nurse Practitioner 8729246723 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chikwendu C Nwosu MD LLCGroup PAC ID 5698950178, 11 clinicians
Stripes Urgent Care LLCGroup PAC ID 4082913058, 7 clinicians

Practice addresses (Care Compare)

2919 S Ellsworth Rd
Suite 139
Mesa, AZ 85212-2168
Phone (480) 984-5225

6820 S Kings Ranch Rd
Suite 130
Gold Canyon, AZ 85118-2959
Phone (480) 246-3411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4338AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Physical Medicine PLLC CurrentSince Aug 7, 2016 Accepting new patients
Chikwendu C Nwosu MD LLC Family CurrentSince Mar 1, 2020 Accepting new patients

Locations

750 S Ironwood Dr
Ste 101
Apache Junction, AZ 85120
Phone (480) 982-1265

6820 S Kings Ranch Rd
Ste 130
Gold Canyon, AZ 85118
Phone (480) 246-3411

6820 S Kings Ranch Rd
Gold Canyon, AZ 85118
Phone (480) 213-3289

2919 S Ellsworth Rd
Ste 101
Mesa, AZ 85212
Phone (480) 305-1000

2919 S Ellsworth Rd
Ste 102
Mesa, AZ 85212
Phone (480) 354-2008

10207 E Hampton Ave
Ste 105
Mesa, AZ 85209
Phone (480) 354-2008

2919 S Ellsworth Rd
Ste 139
Mesa, AZ 85212
Phone (480) 246-3411

Organizations & group practices 3

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1831469733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122165",
            "telephone_number": "480-354-2008",
            "fax_number": "480-907-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122165",
            "telephone_number": "480-354-2008",
            "fax_number": "480-907-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORIEGA",
        "first_name": "VINCENT",
        "middle_name": "M.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-09",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.