Individual provider Active NPI

Adella Deharo, NP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1851799142
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP7424 Issued in AZ
Practice address
337 E Coronado Rd
Suite 201
Phoenix, AZ 85004-1580
Phone
(480) 610-6189
NPI assigned
Dec 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP7424 AZ Primary

Addresses

Primary practice location

337 E Coronado Rd
Suite 201
Phoenix, AZ 85004-1580

Mailing address

2149 E Warner Rd
Suite 102
Tempe, AZ 85284-3494
Phone (480) 610-6189

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
I20150303000407 AZ Practitioner - Nurse Practitioner 1052637477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Hospital Based Physicians LLCGroup PAC ID 1052614294, 343 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP7424AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 6, 2020 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Aug 1, 2017 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 6, 2020 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Aug 1, 2017 Accepting new patients
Southwest Kidney Institute Scottsdale LLC CurrentSince Jan 1, 2015 Accepting new patients

Locations

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

337 E Coronado Rd
Ste 201
Phoenix, AZ 85004
Phone (602) 252-8081

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

2149 E Warner Rd
Ste 101
Tempe, AZ 85284
Phone (480) 610-6111

2149 E Warner Rd
Ste 102
Tempe, AZ 85284
Phone (623) 247-0808

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1851799142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD",
            "address_2": "SUITE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843494",
            "telephone_number": "480-610-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 E CORONADO RD",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041580",
            "telephone_number": "480-610-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHARO",
        "first_name": "ADELLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP7424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.