Individual provider Active NPI

Dana Rae, NP-C

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1972138741
Registry record updated Sep 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
236349 Issued in AZ
Practice address
5421 W Thunderbird Rd
Glendale, AZ 85306-4751
Phone
(888) 698-6727
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 236349 AZ Primary

Addresses

Primary practice location

5421 W Thunderbird Rd
Glendale, AZ 85306-4751

Mailing address

3540 E Crocus Dr
Phoenix, AZ 85032-5347
Phone (888) 698-6727

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
I20200629001266 AZ Practitioner - Nurse Practitioner 6406278092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

14541 W Indian School Rd
Suite 600
Goodyear, AZ 85395-9243
Phone (888) 698-6727

5421 W Thunderbird Rd
Glendale, AZ 85306-4751
Phone (602) 755-0800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Medical Inc. CurrentSince Jun 24, 2020 Accepting new patients
Summit Medical Group Arizona LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

17100 N 67th Ave
Ste 300
Glendale, AZ 85308
Phone (623) 878-8999

5421 W Thunderbird Rd
Ste 110
Glendale, AZ 85306

5421 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 547-9615

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

3003 N Central Ave
Ste 1175
Phoenix, AZ 85012
Phone (346) 980-2701

Interoperability endpoints

  • Direct secure messaging: dana.rae.1@19654.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1972138741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 E CROCUS DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325347",
            "telephone_number": "888-698-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064751",
            "telephone_number": "888-698-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAE",
        "first_name": "DANA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "236349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.