Deepthy Jolal, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8609 Issued in AZ

Practice address

4204 W Cactus Rd
Phoenix, AZ 85029-2924

Phone

(602) 547-5919

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1558308825
  Medicare reassignment Care Compare group NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1386452415
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1912661323
  NPD
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)
• Rhad Health Care LLC

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1780339721
  NPD (past)
• The Little Clinic

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1124482864
  NPD (past)

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1881058238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 W CAVEDALE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850836369",
            "telephone_number": "623-337-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 W CACTUS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292924",
            "telephone_number": "602-547-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLAL",
        "first_name": "DEEPTHY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joint Effort Spine Rehabilitation, LLC
• Joint Performance Inc
• Joint Regenerative LLC
• Mary Minu Joji, MSN,FNP-C
• Breanne Jojola, BCBA
• Sandra Jolley, LMT
• Tyson Max Jolley, DMD
• Melissa Jolliffe
• Heather Jolly, M.A., NCSP
• Rebecca Bryant Jolly

• 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 Apr 12, 2016; 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.