Individual provider Active NPI

Annette H Tuszynski, NP

  • Adult Health Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1982643987
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
160550 Issued in AZ
Practice address
12361 W Bola Dr Ste 100
Surprise, AZ 85378-9021
Phone
(602) 589-0500
Fax
(602) 314-4552
NPI assigned
Jun 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303127-1 NY
Adult Health Nurse Practitioner 363LA2200X 160550 AZ Primary

Addresses

Primary practice location

12361 W Bola Dr Ste 100
Surprise, AZ 85378-9021

Mailing address

5501 N 19TH Ave
Suite 103
Phoenix, AZ 85015-2451
Phone (602) 589-0500

Other identifiers 3

IdentifierTypeStateIssuer
00026502102OtherNYUNIVERA
9512091OtherNYINDEPENDENT HEALTH
02259910MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160550AZMDAdult Health Nurse Practitioner
F303127-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Pain & Wellness Associates, LLC PastSince Feb 28, 2017 Accepting new patients

Organizations & group practices 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982643987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE",
            "address_2": "SUITE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152451",
            "telephone_number": "602-589-0500",
            "fax_number": "602-314-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "602-589-0500",
            "fax_number": "602-314-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSZYNSKI",
        "first_name": "ANNETTE",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303127-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "160550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026502102",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9512091",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02259910",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.