BETH PEMBROKE - NPI 1902304678 - Nurse Practitioner in Phoenix, AZ

Q: What is Beth Pembroke's NPI number?

The NPI number for Beth Pembroke is 1902304678. It was assigned to this individual provider in the NPPES registry on January 29, 2018.

Q: What is Beth Pembroke's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Beth Pembroke was last updated on July 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Beth Pembroke NPPES

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

BETH PEMBROKE (NPI 1902304678) is an individual psychiatric/mental health provider in Phoenix, Arizona, licensed in Arizona (271416) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1902304678

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameBETH PEMBROKE

Location Address16620 N 40TH ST STE E-1Phoenix, AZ 85032-3348

Mailing Address4531 N 16th St Ste 114Phoenix, AZ 85016-5344 · (602) 464-9576

Phone(602) 464-9576

Fax(602) 626-8901

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 29, 2018

Last NPPES UpdateJuly 1, 20253 updates tracked since enumeration

NPPES CertifiedJuly 1, 2025

✔ NPI 1902304678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in AZ · 271416✔ Licensed in UT · 13987096-4405✔ Licensed in CO · C-APN.0102379-C-NP✔ Licensed in NM · 79497✔ Licensed in NY · F405679-01

16620 N 40TH ST STE E-1, Phoenix, AZ 85032

Open in Google Maps ↗

Secondary Practice Locations 4

Location 12304 N Rosemont BlvdTucson, AZ 85712-2139 · Phone (520) 867-4960 · Fax (520) 867-9550

Location 27914 E Sabino Sunrise CirTucson, AZ 85750-9751 · Phone (904) 412-6291

Location 336457 N Gantzel Rd Ste 102San Tan Valley, AZ 85140-7343 · Phone (480) 764-1900 · Fax (480) 764-1902

Location 42001 W Orange Grove Rd Ste 414Tucson, AZ 85704-1141 · Phone (520) 534-2000 · Fax (520) 534-2050

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, BridgeSpan Health Company and more.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

Beth Pembroke 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 ID5991191520

PECOS Enrollment IDI20220504000890

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 85032 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 6

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

TAMMY MCMILLION PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)