Individual provider Active NPI

Osaginwen Kingsley Ayiyi, NP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1871959965
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8375 Issued in AZ
Practice address
3301 E Thomas Rd
Phoenix, AZ 85018-7302
Phone
(602) 899-7774
Fax
(602) 899-7877
NPI assigned
Jan 6, 2016
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 AP8375 AZ Primary

Addresses

Primary practice location

3301 E Thomas Rd
Phoenix, AZ 85018-7302

Mailing address

3301 E Thomas Rd
Phoenix, AZ 85018-7302
Phone (602) 899-7774

Other identifiers 1

IdentifierTypeStateIssuer
230287MedicaidAZ

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
I20160301000876 AZ Practitioner - Nurse Practitioner 8527363423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ternion Physician Group, PLLC Nurse Practitioner CurrentSince Nov 1, 2018 Accepting new patients
Called to Care Medical Center Past Accepting new patients

Locations

3655 W Anthem Way
Ste A109
Anthem, AZ 85086
Phone (623) 505-4479

4704 W Diana Ave
Glendale, AZ 85302
Phone (623) 247-3949

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1871959965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187302",
            "telephone_number": "602-899-7774",
            "fax_number": "602-899-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187302",
            "telephone_number": "602-899-7774",
            "fax_number": "602-899-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYIYI",
        "first_name": "OSAGINWEN",
        "middle_name": "KINGSLEY",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230287",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.