Individual provider Active NPI

Megan Sitrin, MSN,RN, ACNP-BC

  • Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1942784632
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP7659 Issued in AZ
Practice address
1223 Willow Creek Rd
Prescott, AZ 86301-1427
Phone
(928) 777-9950
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X AP7659 AZ
Nurse Practitioner 363L00000X AP7659 AZ Primary

Addresses

Primary practice location

1223 Willow Creek Rd
Prescott, AZ 86301-1427

Mailing address

1223 Willow Creek Rd
Prescott, AZ 86301-1427
Phone (928) 777-9950

Other identifiers 1

IdentifierTypeStateIssuer
AP7659OtherAZNP CERTIFICATE

Other names 1

  • Megan Fernow Former name

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
I20190117001384 AZ Practitioner - Nurse Practitioner 9638415326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granite Orthopaedics PLLCGroup PAC ID 6305025669, 12 clinicians

Practice addresses (Care Compare)

2960 N Centre CT
Prescott Valley, AZ 86314-2295
Phone (928) 777-9950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP7659AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Granite Orthopaedics PLLC Orthopaedic Surgery CurrentSince Oct 8, 2018 Accepting new patients
Granite Orthopaedics, PLLC CurrentSince Oct 8, 2018 Accepting new patients

Locations

1223 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-3055

3195 Stillwater Dr
Ste D
Prescott, AZ 86305
Phone (928) 443-9753

2960 N Centre Ct
Prescott Valley, AZ 86314
Phone (928) 777-9950

Organizations & group practices 2

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1942784632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011427",
            "telephone_number": "928-777-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011427",
            "telephone_number": "928-777-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITRIN",
        "first_name": "MEGAN",
        "credential": "MSN,RN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "AP7659",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP7659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP CERTIFICATE",
            "identifier": "AP7659",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "FERNOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.