Michael Derek Jaorasdr, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219543 Issued in AZ

Practice address

100 E Camelback Rd Ste 108
Phoenix, AZ 85012-1061

Phone

(602) 354-3925

Fax

(602) 354-3768

NPI assigned

Feb 7, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Identity Hormones LLC

  • Adult Medicine Physician
  • Phoenix, AZ
  • NPI 1326642372
  NPD

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1851697007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CAMELBACK RD STE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121061",
            "telephone_number": "602-796-9867",
            "fax_number": "480-664-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CAMELBACK RD STE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121061",
            "telephone_number": "602-354-3925",
            "fax_number": "602-354-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAORASDR",
        "first_name": "MICHAEL",
        "middle_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-07",
        "last_updated": "2024-02-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "219543",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Peter Jantz, DMD
• Taylor Lauren Janulewicz, RDN
• Colette M Januszewski, P.T.
• Mickey Janzen, RN, BSN
• Michelle Agana Jao-Velasquez, MD
• Jena C Jaquez, RBT
• Flor Jara Castaneda
• Ryan Renee' Jara-Bersch, RN
• Christian Jara, MD
• Mohammad M Jaradat, MD

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.