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REGINA MARIE FORMENTIN NP-C
NPI 1700470275
Nurse Practitioner in Mesa, AZ

Active since February 25, 2021PECOS EnrolledAccepts Medicare Assignment
6242 E ARBOR AVE STE 111, MESA, AZ 85206(602) 755-0800(602) 560-2721 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Regina Marie Formentin Np-c NPPES

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

REGINA MARIE FORMENTIN NP-C (NPI 1700470275) is an individual nurse practitioner in Mesa, Arizona, licensed in Arizona (254655) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1700470275
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameREGINA MARIE FORMENTINCredential: NP-C
Location Address6242 E ARBOR AVE STE 111Mesa, AZ 85206-1309
Mailing Address11500 E Cochise Dr Unit 2104Scottsdale, AZ 85259-4931 · (734) 309-9908
Phone(602) 755-0800
Fax(602) 560-2721
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 25, 2021
Last NPPES UpdateAugust 27, 2024
NPPES CertifiedAugust 27, 2024
✔ NPI 1700470275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in AZ · 254655
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.
6242 E ARBOR AVE STE 111, Mesa, AZ 85206
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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, Cigna HealthCare of Arizona, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Regina Marie Formentin Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163890955
PECOS Enrollment IDI20221129002151
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Regina Formentin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pophealthcare Medical Services Of Az, PC
15 mi
Family
1438 W BROADWAY RD STE 101
Tempe, AZ 85282
  • Reassigned Medicare billing, Arizona enrollment
  • 41 clinicians in this Medicare group
NPI 1417652454 (877) 358-8109
Summit Medical Group Arizona LLC
31 mi
Family Medicine
5620 W THUNDERBIRD RD STE F1
Glendale, AZ 85306
  • Reassigned Medicare billing, Arizona enrollment
  • 251 clinicians in this Medicare group
NPI 1053810622 (844) 969-0686

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
114 services84 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
61 services58 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
25 services20 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
21 services21 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
17 services17 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85206 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.

Other Providers at the Same Location NPPES

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

ENDEAVOR MOBILE MEDICAL, LLC
Internal Medicine
6242 E ARBOR AVE STE 111
MESA, AZ 85206
Maricopa County (801) 391-4179

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 Regina Formentin's NPI number?

The NPI number for Regina Formentin is 1700470275. It was assigned to this individual provider in the NPPES registry on February 25, 2021.

Where is Regina Formentin located?

Regina Formentin practices at 6242 E Arbor Ave Ste 111, Mesa, AZ 85206. The listed phone number is (602) 755-0800.

What is Regina Formentin's specialty?

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

Is Regina Formentin enrolled in Medicare?

Yes. Regina Formentin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Regina Formentin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Regina Formentin reassigns Medicare benefits to 2 organizations: Pophealthcare Medical Services Of Az, PC (Tempe, AZ) and Summit Medical Group Arizona LLC (Glendale, AZ). Each 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 Regina Formentin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Regina Formentin accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. list Regina Formentin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Regina Formentin was last updated on August 27, 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.