Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Pedregosa Dy

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1780288852

Ian Pedregosa Dy is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2020, 6 years ago. Practices with Mind 247 Practice LLC, a 32-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
6
Licensed in
AZ
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

815 E Rose Ln Unit 117
Phoenix, AZ 85014-1915
Phone: (480) 280-8690
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 250388 (AZ)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 250388 (AZ)

Record details

NPI number1780288852
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 30, 2020
Last updated in NPPESApril 8, 2024
Certification dateApril 8, 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 Mind 247 Practice Llc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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