Individual provider Active NPI

Marisa Valandra, PMHNP

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1902051071
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3088 Issued in AZ
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(877) 389-2727
NPI assigned
Nov 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP3088 AZ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP-3088 AZ

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

10947 E Adobe Rd
Mesa, AZ 85207-3150
Phone (602) 326-4786

Other practice location 1

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806
Phone (602) 230-7373

Other practice location 2

610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536
Phone (602) 230-7373

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
I20081230000109 AZ Practitioner - Nurse Practitioner 8527129790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

610 E Baseline Rd
Suite C 5
Phoenix, AZ 85042-6536
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3088AZMDFamily Nurse Practitioner
AP-3088AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince May 8, 2024 Accepting new patients
Denova Collaborative Health, LLC CurrentSince May 8, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC Past Accepting new patients

Locations

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

610 E Baseline Rd
Ste C5
Phoenix, AZ 85042

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

Interoperability endpoints

  • Direct secure messaging: denova.marisavalandra@141317.advancedmd-direct.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1902051071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10947 E ADOBE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073150",
            "telephone_number": "602-326-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "877-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 N Central Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122806",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-257-8029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 E Baseline Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850426536",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-441-5836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALANDRA",
        "first_name": "MARISA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3088",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP-3088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.