Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1356911994 Individual Practitioner Female Practitioner

Carolyn Dimiceli

Nurse Practitioner • Phoenix, AZ

Professional Overview & Biography Verified Profile Summary

Carolyn Dimiceli is a registered healthcare professional specializing in Nurse Practitioner in Phoenix, AZ. Practice services are available at 4434 N 12TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4434 N 12th St

Phoenix, AZ 850144507

Telephone 6022425121
Fax 6022426945
Associated Practice Facility / Clinic
🏢 Phoenix Pediatrics Ltd Facility NPI 1871788513

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.2 Yrs
State Avg: 8.9 Yrs
Regional Practice Density
337 Specialists

Practicing in Phoenix, AZ (1459 Statewide)

Telehealth Adoption Rate
14.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-27
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License AZ 259820

(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.

Nurse Practitioner - Pediatrics

NUCC Taxonomy Code: 363LP0200X

State License AZ 259820

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
104847 (AZ)

Secondary Practice Locations

5940 W Union Hills Dr Ste D100

Glendale, AZ 853081361

Phone: 6026782500

4735 E Union Hills Dr

Phoenix, AZ 850503362

Phone: 6029715121

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
NPI 1053491316

Doctor of Medicine (M.D.)

Zackary Patton

Pediatrics

NPI 1093400798
Vicki Simpson , CPNP

Nurse Practitioner - Pediatrics

NPI 1124224399

Certified Pediatric Nurse Practitioner

NPI 1356960959

Doctor of Medicine (M.D.)

NPI 1396780755

Doctor of Medicine (M.D.)

Dr. Gerald Golner , MD

Pediatrics - Adolescent Medicine

NPI 1407947047

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location June 27, 2025

Registered at 4434 N 12TH ST, PHOENIX, AZ 850144507 (Tel: 6022425121)

📍
Updated Business Mailing Address June 27, 2025

Registered at 4434 N 12TH ST, PHOENIX, AZ 850144507 (Tel: 6022425121)

📍
Updated Practice Location May 22, 2024

Registered at 5940 W UNION HILLS DR STE D100, GLENDALE, AZ 853081361 (Tel: 6026782500)

📍
Updated Business Mailing Address May 22, 2024

Registered at 5940 W UNION HILLS DR STE D100, GLENDALE, AZ 853081361 (Tel: 6026782500)

NPI Profile Active June 27, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 27, 2021

Registered at 7875 E FLORENTINE RD STE 4, PRESCOTT VALLEY, AZ 863142284 (Tel: 9284435599)

📍
Updated Business Mailing Address June 27, 2021

Registered at 4433 W KEATING CIR, GLENDALE, AZ 853083503 (Tel: 6026954636)

👤
Provider Name / Credentials Updated June 27, 2021

Recorded as CAROLYN DIMICELI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2021

Nurse Practitioner (License #259820 in AZ)

🟢
Initial NPI Registration & Enumeration June 27, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356911994
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 27, 2021
Last Update: June 27, 2025
Sole Proprietor: Yes

Mailing Address

4434 N 12th St

Phoenix, AZ 850144507

Phone: 6022425121

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.