CAROLYN DIMICELI
NPI 1356911994
Nurse Practitioner in Phoenix, AZ

Q: What is Carolyn Dimiceli's NPI number?

The NPI number for Carolyn Dimiceli is 1356911994. It was assigned to this individual provider in the NPPES registry on June 27, 2021.

Q: What is Carolyn Dimiceli's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Carolyn Dimiceli was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since June 27, 2021

4434 N 12TH ST, PHOENIX, AZ 85014(602) 242-5121(602) 242-6945 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2025, Jun 27, 2021 (2 updates tracked since 2021).

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About Carolyn Dimiceli NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROLYN DIMICELI (NPI 1356911994) is an individual nurse practitioner in Phoenix, Arizona, licensed in Arizona (259820) and active in the NPI registry since June 2021. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1356911994

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameCAROLYN DIMICELI

Location Address4434 N 12TH STPhoenix, AZ 85014-4507

Mailing Address4434 N 12th StPhoenix, AZ 85014-4507 · (602) 242-5121 · Fax (602) 242-6945

Phone(602) 242-5121

Fax(602) 242-6945

Sole ProprietorYes

Enumeration DateJune 27, 2021

Last NPPES UpdateJune 27, 20252 updates tracked since enumeration

NPPES CertifiedJune 27, 2025

✔ NPI 1356911994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in AZ · 259820

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License 259820 (AZ)

4434 N 12TH ST, Phoenix, AZ 85014

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Secondary Practice Locations 2

Location 15940 W Union Hills Dr Ste D100Glendale, AZ 85308-1361 · Phone (602) 678-2500 · Fax (602) 938-2198

Location 24735 E Union Hills DrPhoenix, AZ 85050-3362 · Phone (602) 971-5121 · Fax (602) 971-3122

Other Identifiers 1

Medicaid104847AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZACKARY WILLIAM PATTON

Pediatrics