MS. ILYSSA BAIN PNP-AC
NPI 1588322770
Nurse Practitioner - Pediatrics in Phoenix, AZ

Q: What is Ilyssa Bain's NPI number?

The NPI number for Ilyssa Bain is 1588322770. It was assigned to this individual provider in the NPPES registry on December 4, 2021.

Q: What is Ilyssa Bain's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Ilyssa Bain was last updated on February 22, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 04, 2021PECOS Enrolled

1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-1900 Get Directions Write a Review

NPPES record last updated: February 22, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2022, Dec 4, 2021 (2 updates tracked since 2021).

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About Ms. Ilyssa Bain Pnp-ac NPPES

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

MS. ILYSSA BAIN PNP-AC (NPI 1588322770) is an individual pediatrics provider in Phoenix, Arizona, licensed in Arizona (259452) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588322770

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMS. ILYSSA BAINCredential: PNP-AC

Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710

Mailing Address2108 E Thomas Rd Ste 130Phoenix, AZ 85016-7761 · (602) 933-1813

Phone(602) 933-1900

Sole ProprietorNo

Enumeration DateDecember 4, 2021

Last NPPES UpdateFebruary 22, 20242 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2024

✔ NPI 1588322770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in AZ · 259452

1919 E THOMAS RD, Phoenix, AZ 85016

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Other Identifiers 1

Medicaid120424AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Ilyssa Bain Pnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

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

DR. TIMUR RAGHIB M.D.

Hospitalist