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: July 19, 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
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

Accepted Insurance

Medicare Participation & PECOS CMS

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

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.

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.

Internal Medicine
6242 E ARBOR AVE STE 111
MESA, AZ 85206

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700470275, enumerated as an "individual" on February 25, 2021.

The provider is located at 6242 E ARBOR AVE STE 111 MESA, AZ 85206 and the phone number is (602) 755-0800.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Blue Cross. Please consult your insurance carrier or call the provider to verify.