Stephanie Juliet Mahooty, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP3997 Issued in AZ

Practice address

612 W Baseline Rd
Mesa, AZ 85210-6041

Phone

(480) 834-9039

Fax

(480) 964-7802

NPI assigned

Apr 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX, NM3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Salt River Pima-Maricopa Indian CommunityGroup PAC ID 6204078025, 43 clinicians

Desert Kidney Associates PLCGroup PAC ID 4284611286, 27 clinicians

DHHS,PHS,Naihs, Gallup Indian Medical CenterGroup PAC ID 3173436409, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gallup Indian Medical Center Hospital, Gallup, NM, CCN 320061

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smahooty32580@direct.acumenmd.com
• Direct secure messaging: stephanie.mahooty.p1@direct.kp-hc.nextgenshare.com
• Direct secure messaging: smahooty9365@ahs.direct-ci.com

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.

• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  Medicare reassignment Care Compare group NPD
• Salt River Pima-Maricopa Indian Community

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1942668991

  TX

  Medicare reassignment Care Compare group NPD
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment Care Compare group NPD
• Gila River Health Care Corporation

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888

  TX

  Medicare reassignment NPD
• Gila River Health Care

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Salt River Pima-Maricopa Indian Community

  • Community/Behavioral Health Agency
  • Scottsdale, AZ
  • NPI 1497000293
  NPD
• Salt River Pima-Maricopa Indian Community

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1538583125
  NPD
• Renal Medicine Associates LTD.

  • Specialist
  • Albuquerque, NM
  • NPI 1356347439
  NPD
• Renal Dimensions, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Queen Creek, AZ
  • NPI 1003976010
  NPD (past)
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)

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

{
    "created_epoch": "1304121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1922399542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106041",
            "telephone_number": "480-834-9039",
            "fax_number": "809-647-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106041",
            "telephone_number": "480-834-9039",
            "fax_number": "480-964-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHOOTY",
        "first_name": "STEPHANIE",
        "middle_name": "JULIET",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-30",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "R48437",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP02584",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Mahmood, RBT
• Brenna Mahoney
• Christine Marie Mahoney, RN
• Kyle Mahoney, PT, DPT
• Natalia Mahoney
• Main Street Dental, Inc
• Heather L Main, ADMINISTRATOR, OWNER
• Kate Ashley Maine, PA-C
• Mainstream Dental
• Amber Lynn Maison, PA-C

• Adult Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.