MANZANITA MIND INSTITUTE PLLC
NPI 1174385058
Nurse Practitioner - Psychiatric/Mental Health in Tucson, AZ
About Manzanita Mind Institute Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MANZANITA MIND INSTITUTE PLLC (NPI 1174385058) is a healthcare organization registered as a psychiatric/mental health in Tucson, Arizona and active in the NPI registry since January 2024. The organization lists Jolene Jacquart, Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Manzanita Mind Institute Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Manzanita Mind Institute PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Manzanita Mind Institute PLLC's NPI number?
The NPI number for Manzanita Mind Institute PLLC is 1174385058. It was assigned to this organization in the NPPES registry on January 26, 2024.
Where is Manzanita Mind Institute PLLC located?
Manzanita Mind Institute PLLC is located at 3075 N Swan Rd Ste 206, Tucson, AZ 85712. The listed phone number is (520) 230-1065.
What is Manzanita Mind Institute PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Manzanita Mind Institute PLLC enrolled in Medicare?
Yes. Manzanita Mind Institute PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Manzanita Mind Institute PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Manzanita Mind Institute PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Manzanita Mind Institute PLLC was last updated on January 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Manzanita Mind Institute Pllc · NPI 1174385058
Psychiatric/Mental Health organization in Tucson, Arizona. Organization record, active in the CMS NPPES registry since January 26, 2024.
## Identity
- **NPI:** 1174385058 (Entity type: Organization)
- **Enumerated:** January 26, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jolene Jacquart, MEMBER
## Practice location
- **Address:** 3075 N SWAN RD STE 206, Tucson, AZ 85712-1259
- **Phone:** (520) 230-1065
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 26, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1174385058) · Data from the CMS NPPES public registry.