NPIMap

Individual provider Active NPI

Jessica Maria Nino Mojica, MD

  • Nephrology Physician
  • Tucson, AZ
National Provider Identifier
1922584796
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
71798 Issued in AZ
Practice address
1704 W Anklam Rd Ste 107
Tucson, AZ 85745-2656
Phone
(520) 622-3569
Fax
(520) 623-7257
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P09657 NY
Nephrology Physician 207RN0300X R79324 AZ
Nephrology Physician 207RN0300X 71798 AZ Primary

Addresses

Primary practice location

1704 W Anklam Rd Ste 107
Tucson, AZ 85745-2656

Mailing address

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone (520) 634-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819004403 AZ Practitioner - Nephrology 9032657226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians

Practice addresses (Care Compare)

1704 W Anklam Rd
Suite 107
Tucson, AZ 85745-2656
Phone (520) 622-3569

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P09657NYMDEmergency Medicine Physician
71798AZMDNephrology Physician
R79324AZMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akdhc, LLC Nephrology CurrentSince Aug 15, 2024 Accepting new patients
Akdhc, LLC Nephrology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Aug 15, 2024 Accepting new patients
Akdhc Surgery Center, LLC Nephrology Current Accepting new patients

Locations

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

3333 E Camelback Rd
Ste 180
Phoenix, AZ 85018
Phone (602) 997-0484

1704 W Anklam Rd
Ste 10
Tucson, AZ 85745

1704 W Anklam Rd
Ste 107
Tucson, AZ 85745
Phone (502) 622-5912

Interoperability endpoints

  • Direct secure messaging: jessica.nino.mojica.1@11625.direct.athenahealth.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.

Hospital & facility affiliations 10

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1922584796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "520-634-8888",
            "fax_number": "602-224-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 W ANKLAM RD STE 107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452656",
            "telephone_number": "520-622-3569",
            "fax_number": "520-623-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINO MOJICA",
        "first_name": "JESSICA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "P09657",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "R79324",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "71798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.