Individual provider Active NPI

Mary Biju, MSN-FNP -C

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1942985114
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
293860 Issued in AZ
Practice address
4330 E University Dr
Mesa, AZ 85205-7004
Phone
(480) 218-3280
Fax
(480) 324-2463
NPI assigned
Jun 16, 2023
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 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 293860 AZ Primary
Medical-Surgical Registered Nurse 163WM0705X RN139148 AZ

Addresses

Primary practice location

4330 E University Dr
Mesa, AZ 85205-7004

Mailing address

5099 W Dobbins Rd
Laveen, AZ 85339-9733

Other practice location 1

5099 W Dobbins Rd
Laveen, AZ 85339-9733
Phone (602) 824-8140

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
I20231220002820 AZ Practitioner - Nurse Practitioner 9830549609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Recovery LLCGroup PAC ID 9638212301, 32 clinicians

Practice addresses (Care Compare)

4330 E University Dr
East Valley Campus
Mesa, AZ 85205-7004
Phone (480) 218-3280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Recovery, LLC CurrentSince Nov 5, 2023 Accepting new patients
Partners in Recovery, LLC CurrentSince Nov 5, 2023 Accepting new patients
Partners in Recovery, LLC Current Accepting new patients

Locations

4330 E University Dr
Mesa, AZ 85205
Phone (480) 218-3280

924 N Country Club Dr
Mesa, AZ 85201
Phone (480) 696-3800

10240 N 31st Ave
Ste 200
Phoenix, AZ 85051
Phone (602) 395-1700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1942985114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5099 W DOBBINS RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853399733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057004",
            "telephone_number": "480-218-3280",
            "fax_number": "480-324-2463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5099 W Dobbins Rd",
            "address_purpose": "LOCATION",
            "city": "Laveen",
            "state": "AZ",
            "postal_code": "853399733",
            "country_code": "US",
            "telephone_number": "602-824-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIJU",
        "first_name": "MARY",
        "credential": "MSN-FNP -C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "293860",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "AZ",
            "license": "RN139148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.