Individual provider Active NPI

Nicknaz Nakhaie Janajreh

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1952930208
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
72610 Issued in AZ
Practice address
1300 N 12TH St Ste 320
Phoenix, AZ 85006-2858
Phone
(602) 521-3600
NPI assigned
Apr 7, 2020
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 72610 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 320
Phoenix, AZ 85006-2858

Mailing address

1300 N 12TH St Ste 320
Phoenix, AZ 85006-2858
Phone (602) 521-3600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113001398 AZ Practitioner - Psychiatry 7911329057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72610AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients

Locations

570 W Brown Rd
Mesa, AZ 85201
Phone (480) 344-2000

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

Interoperability endpoints

  • Direct secure messaging: njanajreh272996@direct.valleywisehealth.org

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, 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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1952930208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 320",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062858",
            "telephone_number": "602-521-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 320",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062858",
            "telephone_number": "602-521-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANAJREH",
        "first_name": "NICKNAZ",
        "middle_name": "NAKHAIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "72610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.