Deanna E. Bertani, FNP
Individual provider Active NPI Family Nurse Practitioner · Phoenix, AZ
NPI 1861022972 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1861022972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 262439 (AZ)
- Practice address
- 2640 W Baseline Rd Ste 111
Phoenix, AZ 85041-6492 - Phone
- (480) 677-8282
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210921000016 | AZ | Practitioner - Nurse Practitioner | 3072940352 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Health Medical, PLLC | Current | Accepting new patients | |
| Good Health Medical, PLLC | Current |
Accepting new patients | |
| Good Health Medical, PLLC | Current |
Accepting new patients | |
| Good Health Medical, PLLC | Past | Accepting new patients | |
| Livn, P.C. | Past | Accepting new patients |
Locations
11435 W Buckeye Rd
Ste A106
Avondale, AZ 85323
Phone (703) 415-6994
261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888
428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400
2632 S 83rd Ave
Ste 113
Phoenix, AZ 85043
2640 W Baseline Rd
Ste 111
Phoenix, AZ 85041
Phone 4803052888 ext. 1109
287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282
Interoperability endpoints
- dcangelosi20518@mydrnow.gardenplot.direct-ci.com
- https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP021389 | PA | |
| Family Nurse Practitioner | 363LF0000X | 262439 | AZ | Yes |
Addresses
Primary practice location
2640 W Baseline Rd Ste 111
Phoenix, AZ 85041-6492
Mailing address
261 N Roosevelt Ave
Chandler, AZ 85226-2616
Phone (480) 677-8282
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099769 | Medicaid | AZ |
Other providers in Phoenix, AZ
- Tyler Berschel
- Benjamin Mark Berschler
- Bert, PLLC
- Tiffany C Bert
- Timothy Michael Bert
- Jack Lee Bertch
- Leigh Taylor Bertie
- Chelsea Aubree Bertolino
- Robin M Bertozzi
- Erin Kathryn Bertram
All providers in Phoenix, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.