Karen Lynn Modrzejewski, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP10946 Issued in AZ

Practice address

13395 N Marana Main St BLDG B
Marana, AZ 85653-7008

Phone

(520) 682-1091

Fax

(520) 682-4132

NPI assigned

Nov 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: karen.modrzejewski@1278.direct.myezyaccess.com
• Direct secure messaging: karen.modrzejewski.1@32652.direct.athenahealth.com

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.

• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405
  Medicare reassignment Care Compare group NPD
• Marana Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1831491059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-818-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST BLDG B",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-1091",
            "fax_number": "520-682-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRZEJEWSKI",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10946",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "114985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354315",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sue Ellen Middagh, LCSW
• Jennifer Miklosi, LPN
• Janice Gritti Miller, PH.D, CCC, SLP
• Mindful Recovery Clinic LLC
• Kellie Denise Mitchell, COTA/L
• Maria Mercedes Molina-Whillock, MS.SLP
• Adolben Y Montesclaros, M.D.
• Tamara Montgomery, LPN
• Timothy Moore, LPC
• Pamela Moorehead, LISAC

• Psychiatric/Mental Health Nurse Practitioner in Marana, AZ
• Providers in Marana, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.