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

MS. Mary Jo Deprey, PA-C

Individual provider Nurse Practitioner · NPI 1629606983

MS. Mary Jo Deprey, PA-C is a Physician Assistant in Phoenix, Arizona. Qualified in 2020, 6 years ago. Practices with Banner Cancer Center Specialists LLC, a 338-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
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

925 E McDowell Rd
Phoenix, AZ 85006-2502
Phone: (602) 521-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8290 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence 8290 (AZ)

Record details

NPI number1629606983
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 31, 2020
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Banner Cancer Center Specialists Llc — 338 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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