Individual provider Active NPI

Deborah Kathleen Rupae, FNP

  • Family Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1902867245
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200150031NP Issued in OR
Practice address
13995 W. Statler Blvd
Surprise, AZ 85374
Phone
(623) 478-3100
Fax
(623) 478-3300
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 AP30005854 WA
Family Nurse Practitioner 363LF0000X 200150031NP OR Primary

Addresses

Primary practice location

13995 W. Statler Blvd
Surprise, AZ 85374

Mailing address

13995 W. Statler Blvd
Ste 200
Surprise, AZ 85374-5501
Phone (623) 478-3100

Other identifiers 1

IdentifierTypeStateIssuer
9645714MedicaidWA

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
I20180201002401 AZ Practitioner - Nurse Practitioner 8921095605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

13995 W Statler Blvd
BLDG 1
Surprise, AZ 85374-5501
Phone (623) 478-3100

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

State licenses

LicenseStateTypeSpecialty
200150031NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Feb 1, 2018 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Feb 1, 2018 Accepting new patients
Deborah K Rupae FNP, PLLC Family PastSince Sep 22, 2003 Accepting new patients
Banner Childrens Banner Health Clinic LLC Past Accepting new patients

Locations

1811 E McMurray Blvd
Casa Grande, AZ 85122
Phone (520) 374-2090

9780 S Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 474-8101

564 W 9th Pl
Ste 2
Mesa, AZ 85201
Phone (480) 412-6344

117 E Main St
Ste A100
Payson, AZ 85541
Phone (928) 474-1714

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

28471 N Vistancia Blvd
Ste 102
Peoria, AZ 85383
Phone (623) 327-8800

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

13995 W Statler Blvd
Bldg 1
Surprise, AZ 85374
Phone (623) 478-3100

15800 N Litchfield Rd
Surprise, AZ 85374

13995 W Statler Blvd
Ste 200
Surprise, AZ 85374
Phone (602) 478-3100

13995 W Statler Blvd
Surprise, AZ 85374
Phone (623) 478-3100

15800 N Litchfield Rd
Ste 150
Surprise, AZ 85374
Phone (623) 478-3100

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 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1902867245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13995 W. STATLER BLVD",
            "address_2": "STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745501",
            "telephone_number": "623-478-3100",
            "fax_number": "623-478-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 W. STATLER BLVD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "623-478-3100",
            "fax_number": "623-478-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPAE",
        "first_name": "DEBORAH",
        "middle_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30005854",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200150031NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9645714",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.