Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Regina Marie Formentin, NP-C

Individual provider Nurse Practitioner · NPI 1700470275

Regina Marie Formentin, NP-C is a Nurse Practitioner in Mesa, Arizona. Qualified in 2020, 6 years ago. Practices with Summit Medical Group Arizona LLC, a 153-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
6
Licensed in
AZ
In the registry since
2021
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

6242 E Arbor Ave Ste 111
Mesa, AZ 85206-1309
Phone: (602) 755-0800
Fax: (602) 560-2721
Show map & directions

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 254655 (AZ)

Record details

NPI number1700470275
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorYes
NPI enumeratedFebruary 25, 2021
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Summit Medical Group Arizona Llc — 153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients140
Services billed 468 a service is one billed item, such as a visit, a test or a procedure
Average patient age78

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Summit Medical Group Arizona LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 153 clinicians in the practice; 12 are shown here.

Other providers in Mesa