VINCENT P EKSTROM (DNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1124644794

VINCENT P EKSTROM (DNP) is a healthcare provider. based in Phoenix, Arizona. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 242271 (AZ). The NPI Number for VINCENT P EKSTROM (DNP) is 1124644794

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
VINCENT P EKSTROM (DNP)
NPI
1124644794
Phone
(602) 489-9606
Address
18628 N 43RD ST
Enumeration Date
19 June 2020
Last Update Date
18 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8446463247
Graduation Year
2020 (6 years ago)
PAC ID
2062838238
Group Practice PAC ID
6406253541
Professional Enrollment ID
I20200818003624
Address ID
AZ852063000ME1138XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

7,509 NURSE PRACTITIONER in AZ

Provider Addresses for VINCENT P EKSTROM (DNP)

  • 18628 N 43RD ST

    PHOENIX, AZ 850503342

    Phone: (602) 489-9606

    Type: Mailing

  • 3110 N CENTRAL AVE STE 200

    PHOENIX, AZ 850122837

    Phone:

    Type: Mailing

  • 500 W THOMAS RD STE 230

    PHOENIX, AZ 850134245

    Phone: (602) 406-9999

    Type: Location

  • 4138 E JOAN DE ARC AVE

    PHOENIX, AZ 850326316

    Phone: (480) 208-3900

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-08-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200818003624INurse PractitionerAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 85050)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406253541View full group profile
NameSpecialtyState
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerWI
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Mental Health CounselorAZ

Reviews

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Frequently asked questions

What is the registry number for VINCENT P EKSTROM (DNP)?
The registry entry for VINCENT P EKSTROM (DNP) shows NPI 1124644794.
Is VINCENT P EKSTROM (DNP) currently accepting referrals based on NPI status?
Registry metadata lists VINCENT P EKSTROM (DNP) as active.
What services align with VINCENT P EKSTROM (DNP)'s listing?
VINCENT P EKSTROM (DNP)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to VINCENT P EKSTROM (DNP)?
VINCENT P EKSTROM (DNP) shows a connection to Phoenix, Arizona in registry-derived data.
Can I export VINCENT P EKSTROM (DNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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