Mind 247 Practice LLC - Medicare Mental Health Clinic in Phoenix, AZ

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Mind 247 Practice LLC is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Phoenix, Arizona. The current practice location for Mind 247 Practice LLC is 2728 N 24th St, Phoenix, Arizona. For appointments, you can reach them via phone at (844) 646-3247. The mailing address for Mind 247 Practice LLC is 1465 N Scottsdale Rd Ste 400, Scottsdale, Arizona and phone number is (844) 646-3247.

Mind 247 Practice LLC is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1902472467. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (844) 646-3247.

Contact Information

Mind 247 Practice LLC
2728 N 24th St
Phoenix
AZ 85008-1050
(844) 646-3247
Not Available

Map and Direction


Mental Health Clinic Profile

Full NameMind 247 Practice LLC
SpecialityClinic/Center
Location2728 N 24th St, Phoenix, Arizona
Authorized Official Name and PositionAisha Lynn Depriest (DIRECTOR OF CREDENTIALING)
Authorized Official Contact4803694008
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mind 247 Practice LLC
1465 N Scottsdale Rd Ste 400
Scottsdale
AZ 85257-3634

Ph: (844) 646-3247		Mind 247 Practice LLC
2728 N 24th St
Phoenix
AZ 85008-1050

Ph: (844) 646-3247

NPI Details:

NPI Number1902472467
Provider Enumeration Date06/03/2021
Last Update Date10/04/2022
Certification Date10/04/2022

Medicare PECOS Information:

Medicare PECOS PAC ID6406253541
Medicare Enrollment IDO20210916001566

Medical Identifiers

Medical identifiers for Mind 247 Practice LLC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902472467NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Mind 247 Practice LLC acts as a billing entity for following providers:
Provider NameVernon Barksdale
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1871547380
PECOS PAC ID: 5698768935
Enrollment ID: I20040405000539
Provider NameJoseph V Gaddam
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1376523407
PECOS PAC ID: 9032167895
Enrollment ID: I20050107000683
Provider NameJohn J Lee
Provider TypePractitioner - Osteopathic Manipulative Medicine
Provider IdentifiersNPI Number: 1568534741
PECOS PAC ID: 9335153881
Enrollment ID: I20060203000413
Provider NameKiyana V Brutus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548327356
PECOS PAC ID: 2668574849
Enrollment ID: I20071023000425
Provider NameAnnette D Bunn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831265354
PECOS PAC ID: 4183694433
Enrollment ID: I20110310000615
Provider NameTarry Wolfe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982655338
PECOS PAC ID: 1052459559
Enrollment ID: I20110606000748
Provider NameKristen Lyn Robinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447545645
PECOS PAC ID: 8527237569
Enrollment ID: I20110809000606
Provider NameJoycelyn Connet
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225377898
PECOS PAC ID: 3870732712
Enrollment ID: I20130625000533
Provider NameRoy Lee Evans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578583209
PECOS PAC ID: 8426108481
Enrollment ID: I20140428000003
Provider NameAdiza J Sulley
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1427369420
PECOS PAC ID: 6305096215
Enrollment ID: I20140721002280
Provider NameChyllia D Dixon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174916472
PECOS PAC ID: 7719298033
Enrollment ID: I20150612000863
Provider NameKimberly Keene
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285004234
PECOS PAC ID: 2668781154
Enrollment ID: I20151023000975
Provider NameMani Murugesan
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1548505175
PECOS PAC ID: 7911203005
Enrollment ID: I20160316001072
Provider NameSusan K Jostes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356776819
PECOS PAC ID: 5799084109
Enrollment ID: I20160505001053
Provider NameLatanya M Willis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225235005
PECOS PAC ID: 8123331071
Enrollment ID: I20160909000431
Provider NameBryan Lazaro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912458845
PECOS PAC ID: 4880976521
Enrollment ID: I20170112003390
Provider NameNadia G Ledesma
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477006989
PECOS PAC ID: 9335421999
Enrollment ID: I20170117001139
Provider NameMirandine a Alce
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841678943
PECOS PAC ID: 3870806821
Enrollment ID: I20170308001654
Provider NameHamda H Awaal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710373923
PECOS PAC ID: 2567769037
Enrollment ID: I20170323000888
Provider NameAdlene Joseph
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063958676
PECOS PAC ID: 2668742248
Enrollment ID: I20170714002635
Provider NameAmy Priftakis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508212960
PECOS PAC ID: 4385915008
Enrollment ID: I20170728002897
Provider NameTanya L Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184116824
PECOS PAC ID: 3779830906
Enrollment ID: I20180719001363
Provider NameLaura Masters
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154793685
PECOS PAC ID: 5092025874
Enrollment ID: I20180801003465
Provider NameMargarita Madrid
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619476207
PECOS PAC ID: 6901150028
Enrollment ID: I20181108000733
Provider NameMark Gregory Sonenschein
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457816597
PECOS PAC ID: 5991046542
Enrollment ID: I20190408001778
Provider NameRosalind Marie Huff
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1275091043
PECOS PAC ID: 6901148972
Enrollment ID: I20190424000826
Provider NamePhillis C Mutembete
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215230081
PECOS PAC ID: 3476895269
Enrollment ID: I20190426000476
Provider NamePatience R Akhimien
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346617594
PECOS PAC ID: 8729397773
Enrollment ID: I20190604000948
Provider NameAmy Renee Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457905812
PECOS PAC ID: 2264764182
Enrollment ID: I20191025002561
Provider NameAlbert Kenneth Pierce
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841850377
PECOS PAC ID: 0547692584
Enrollment ID: I20191113002826
Provider NameKevin Demarcus Lowrey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407499635
PECOS PAC ID: 1658706536
Enrollment ID: I20200123000474
Provider NameShannon Janine Crawford-west
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275164337
PECOS PAC ID: 3173951456
Enrollment ID: I20200319002854
Provider NameFrancis Kangere Kahiga
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477185759
PECOS PAC ID: 2567891773
Enrollment ID: I20200408003598
Provider NameJacob Johns
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235779737
PECOS PAC ID: 1456772193
Enrollment ID: I20200604000461
Provider NameKetura C James
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548508237
PECOS PAC ID: 4284860529
Enrollment ID: I20200706000167
Provider NameVincent P Ekstrom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124644794
PECOS PAC ID: 2062838238
Enrollment ID: I20200818003624
Provider NameSylicia E Mcphea
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1467063453
PECOS PAC ID: 8527487834
Enrollment ID: I20201005002640
Provider NameToni R Crawford-jonas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467069567
PECOS PAC ID: 2062832132
Enrollment ID: I20201012002777
Provider NameTerri Collins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831702513
PECOS PAC ID: 9436569316
Enrollment ID: I20201104000837
Provider NameFlora Issanda Stowater
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700274321
PECOS PAC ID: 2961813571
Enrollment ID: I20201202001632
Provider NameYolanda Baugh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215536479
PECOS PAC ID: 5890108542
Enrollment ID: I20210119002261
Provider NameGwendolyn Mathis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194183137
PECOS PAC ID: 0143529677
Enrollment ID: I20210129001123
Provider NameAmanda Kate Long
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295376945
PECOS PAC ID: 0941626527
Enrollment ID: I20210224001327
Provider NamePaulette D Winsor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568054195
PECOS PAC ID: 7012324817
Enrollment ID: I20210323001094
Provider NameKenneth a Nembu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841810371
PECOS PAC ID: 9335556430
Enrollment ID: I20210407000442
Provider NameJennifer Steele
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487249710
PECOS PAC ID: 7416365531
Enrollment ID: I20210409000225
Provider NameKelly L Heffron
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043895030
PECOS PAC ID: 7416365077
Enrollment ID: I20210420001124
Provider NameAlyssa Bruns
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1841815230
PECOS PAC ID: 1254740707
Enrollment ID: I20210512003386
Provider NameJerica Elaine M Lim
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043884026
PECOS PAC ID: 7618379447
Enrollment ID: I20210715001933
Provider NameNikka Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962939454
PECOS PAC ID: 4082040928
Enrollment ID: I20210819003588
Provider NameRachel L Bardos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265003081
PECOS PAC ID: 4385049360
Enrollment ID: I20210830001975
Provider NameDelphine Valentin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982205944
PECOS PAC ID: 7618375841
Enrollment ID: I20211001001733
Provider NameDorothy C Igwe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073038824
PECOS PAC ID: 9739577107
Enrollment ID: I20211104001097
Provider NameShawn Dugan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841825155
PECOS PAC ID: 7618391483
Enrollment ID: I20211111000623
Provider NameLimy Fernandus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972005189
PECOS PAC ID: 8820424070
Enrollment ID: I20211216002411
Provider NameLakshmi Nair
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720588742
PECOS PAC ID: 2769731819
Enrollment ID: I20220202002667
Provider NameCaroline Miya
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992266712
PECOS PAC ID: 7012301278
Enrollment ID: I20220303002147
Provider NameStephanie Jeanette Dockins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114559366
PECOS PAC ID: 5597150318
Enrollment ID: I20220315000277
Provider NameHunter Marteney
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1346902293
PECOS PAC ID: 3870980337
Enrollment ID: I20220502000990
Provider NameJose Rodriguez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669086641
PECOS PAC ID: 4183043383
Enrollment ID: I20220606002043
Provider NameMojisola R Balogun
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144567264
PECOS PAC ID: 7012255904
Enrollment ID: I20220606002368
Provider NameKengne Fosso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386308864
PECOS PAC ID: 3375924269
Enrollment ID: I20220725000789
Provider NameMarquita Lagarde
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1902247570
PECOS PAC ID: 0749662567
Enrollment ID: I20220726002926
Provider NameZakary Call
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1699323469
PECOS PAC ID: 5597148262
Enrollment ID: I20220812000310
Provider NameFunmilayo Oluwole
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780115345
PECOS PAC ID: 1759650468
Enrollment ID: I20220826000542
Provider NameTamara Perryman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255688339
PECOS PAC ID: 5496773244
Enrollment ID: I20220926003300
Provider NameIan Pedregosa Dy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780288852
PECOS PAC ID: 6901212653
Enrollment ID: I20221004000767
Provider NameVanessa Arvizu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225773468
PECOS PAC ID: 2567848898
Enrollment ID: I20221010002317
Provider NameLafayette Bishop
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588387989
PECOS PAC ID: 4587033063
Enrollment ID: I20221205001814
Provider NameJulie a Bainbridge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073237210
PECOS PAC ID: 3274902234
Enrollment ID: I20221213003311
Provider NameKindra Ochoa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831816370
PECOS PAC ID: 4082083050
Enrollment ID: I20221214000281
Provider NameMichael S Moore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588339923
PECOS PAC ID: 7012391816
Enrollment ID: I20221219001197
Provider NameJennifer Lynn Ruth Beaupre
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437823143
PECOS PAC ID: 1759787112
Enrollment ID: I20230125001328
Provider NameJames N Maigua
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912614611
PECOS PAC ID: 8921479080
Enrollment ID: I20230127001013
Provider NamePreston Jay Frank
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720704851
PECOS PAC ID: 1759753619
Enrollment ID: I20230202002480
Provider NameAbbas Ghazi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124735006
PECOS PAC ID: 9133591837
Enrollment ID: I20230206002661
Provider NameIdorenyin Philip
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639886583
PECOS PAC ID: 6800268236
Enrollment ID: I20230329000831
Provider NameAnna Lavette Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801594890
PECOS PAC ID: 5395100556
Enrollment ID: I20230424001611
Provider NameDebra K Gibson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811694482
PECOS PAC ID: 4486019478
Enrollment ID: I20230426001900
Provider NameTyler Weber
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457056582
PECOS PAC ID: 3072978964
Enrollment ID: I20230427003008
Provider NameJamie Wade
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225730997
PECOS PAC ID: 9234596305
Enrollment ID: I20230605002198
Provider NameKyle Olson
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1114699915
PECOS PAC ID: 2769849439
Enrollment ID: I20230612001739
Provider NameOma Gama
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1609800739
PECOS PAC ID: 1456379015
Enrollment ID: I20230807003901
Provider NameMarcus Ernest Konyi Kometa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003522954
PECOS PAC ID: 4688036692
Enrollment ID: I20230808002078
Provider NameAshleigh Michelle Mcdonnell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023789963
PECOS PAC ID: 8224492434
Enrollment ID: I20230906003147
Provider NameKara Ann Masters
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770263642
PECOS PAC ID: 2961857883
Enrollment ID: I20231012003497
Provider NameRebecca Jensen
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1699218008
PECOS PAC ID: 7214387265
Enrollment ID: I20240103001389
Provider NameFelicia D Thomas
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1134801053
PECOS PAC ID: 2961855283
Enrollment ID: I20240201004273
Provider NameOghenero E Olori
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689441636
PECOS PAC ID: 7618419136
Enrollment ID: I20240611003628
Provider NameAndrea Hinton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942067533
PECOS PAC ID: 7719420439
Enrollment ID: I20240621001683
Provider NameLacy Garth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063266658
PECOS PAC ID: 6103358056
Enrollment ID: I20241016002366
Provider NameMary Katherine Garcia
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1932541372
PECOS PAC ID: 1759814072
Enrollment ID: I20241024004315
Provider NameCarley Mccarthy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437827284
PECOS PAC ID: 3678947736
Enrollment ID: I20241031003241
Provider NameElizabeth M Giroux
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1477301398
PECOS PAC ID: 3375076995
Enrollment ID: I20241104001682
Provider NameMelinda K Callicoat
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1811252554
PECOS PAC ID: 6507390002
Enrollment ID: I20241106001987
Provider NameEmily R Ratliff
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1831957190
PECOS PAC ID: 6709311269
Enrollment ID: I20241121001465
Provider NameCrystal Mccarthy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821754300
PECOS PAC ID: 4981125366
Enrollment ID: I20250303001558
Provider NameTroy D. E. Curtis
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1689457327
PECOS PAC ID: 5496271249
Enrollment ID: I20250428001123
Provider NameVictor Morrison Wangathika
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548981376
PECOS PAC ID: 1557877479
Enrollment ID: I20250718001124
Provider NameMarinette Nombu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124841358
PECOS PAC ID: 3971004086
Enrollment ID: I20250829003153
Provider NameGrace Kalt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1114746658
PECOS PAC ID: 1658853072
Enrollment ID: I20260304004415
Provider NameKiara Tellez
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1487150207
PECOS PAC ID: 8729558598
Enrollment ID: I20260522000259
Provider NameKristy Gonzalez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134943251
PECOS PAC ID: 3577033067
Enrollment ID: I20260526002690
Provider NameMichael Gibson
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1295683365
PECOS PAC ID: 6709357296
Enrollment ID: I20260605000546
Provider NameChristy Brinton
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1396552485
PECOS PAC ID: 5890266175
Enrollment ID: I20260608002626
Provider NameBrenda Elizabeth Jaime
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366206286
PECOS PAC ID: 9931672441
Enrollment ID: I20260625004020

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.