Mrs Jetta Valle, MSN, PMHNP, FNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" physician in Queen Creek, Arizona. Her current practice location is
21168 E Ocotillo Rd # 1271, Queen Creek, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 677-8025.
Mrs Jetta Valle is licensed to practice in Arizona (license number AP10652) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1720336910.
Physician's Profile
| Full Name | Mrs Jetta Valle |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 21168 E Ocotillo Rd # 1271, Queen Creek, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720336910
- Provider Enumeration Date: 08/21/2012
- Last Update Date: 08/24/2025
Medicare PECOS Information:
- PECOS PAC ID: 5991953911
- Enrollment ID: I20161104001850
Medical Identifiers
Medical identifiers for Mrs Jetta Valle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720336910 | NPI | - | NPPES |
| 204924 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QA0401X | Family Medicine - Addiction Medicine | AP10652 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP10652 (Arizona) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | AP10652 (Arizona) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP10652 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Jetta Valle allows following entities to bill medicare on her behalf.
| Entity Name | Dhhs Phs Naihs Shiprock Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780639971
PECOS PAC ID: 0749193837
Enrollment ID: O20031105000809 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jetta Valle is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Jetta Valle, MSN, PMHNP, FNP
21168 E Ocotillo Rd # 1271,
Queen Creek, AZ 85142-8175
Ph: (520) 677-8025 | Mrs Jetta Valle, MSN, PMHNP, FNP
21168 E Ocotillo Rd # 1271,
Queen Creek, AZ 85142-8175
Ph: (520) 677-8025 |
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