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IDRIS A IDRIS NP
NPI 1710545355
Nurse Practitioner - Family in Glendale, AZ

Active since May 30, 2019PECOS Enrolled
3515 W UNION HILLS DR STE 111, GLENDALE, AZ 85308(623) 328-8630(623) 243-7842 Get Directions Write a Review

NPPES record last updated: July 22, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 22, 2019, May 30, 2019 (2 updates tracked since 2019).

About Idris A Idris Np NPPES

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

IDRIS A IDRIS NP (NPI 1710545355) is an individual family provider in Glendale, Arizona, licensed in Arizona (F01190538) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710545355
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameIDRIS A IDRISCredential: NP
Location Address3515 W UNION HILLS DR STE 111Glendale, AZ 85308-2430
Mailing Address3515 W Union Hills Dr Ste 111Glendale, AZ 85308-2430 · (623) 328-8630 · Fax (623) 243-7842
Phone(623) 328-8630
Fax(623) 243-7842
Sole ProprietorYes
Enumeration DateMay 30, 2019
Last NPPES UpdateJuly 22, 20192 updates tracked since enumeration
✔ NPI 1710545355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · F01190538
3515 W UNION HILLS DR STE 111, Glendale, AZ 85308
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Idris A Idris Np 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.

Medicare Billing Reassignments

2

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

Gadstar, P.C.
Same address
Family Medicine
3515 W UNION HILLS DR STE 111
Glendale, AZ 85308
  • Reassigned Medicare billing, Arizona enrollment
  • Medicare enrollment name: Gadstar PC
  • 4 clinicians in this Medicare group
NPI 1649719071 (623) 328-8630
Signify Health, LLC
886 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Arizona enrollment
  • 556 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85308 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 3

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

BASSEM REZK
Internal Medicine
3515 W UNION HILLS DR STE 111
GLENDALE, AZ 85308
Maricopa County (929) 308-5775
DR. SOUSOU GAD AWAD MD
Family Medicine
3515 W UNION HILLS DR STE 111, 623-243-7842
GLENDALE, AZ 85308
Maricopa County (623) 328-8630
GADSTAR, P.C.
Family Medicine
3515 W UNION HILLS DR STE 111
GLENDALE, AZ 85308
Maricopa County (623) 328-8630

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 Idris Idris's NPI number?

The NPI number for Idris Idris is 1710545355. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Where is Idris Idris located?

Idris Idris practices at 3515 W Union Hills Dr Ste 111, Glendale, AZ 85308. The listed phone number is (623) 328-8630.

What is Idris Idris's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Idris Idris enrolled in Medicare?

Yes. Idris Idris is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Idris Idris's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Idris Idris reassigns Medicare benefits to 2 organizations: Gadstar, P.C. (Glendale, AZ) and Signify Health, LLC (Dallas, TX). 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 Idris Idris's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Idris Idris was last updated on July 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.