Leloole Sole Barika, F.N.P.
Individual provider Active NPI Family Nurse Practitioner · Peridot, AZ
NPI 1124315908 · NPPES record last updated Oct 17, 2019
Key facts
- NPI
- 1124315908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 220610 (AZ)
- Practice address
- 103 Medicine Way Road
Peridot, AZ 85542-0787 - Phone
- (928) 475-1400
- NPI assigned
- Jun 30, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Bridges Inc
Practice addresses (Care Compare)
358 E Javelina Ave
Suite 101
Mesa, AZ 85210-6205
Phone (480) 507-3180
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190910001404 | TX | Practitioner - Nurse Practitioner | 6901135359 | Reassigns benefits to 2 organizations |
| I20191210002015 | AZ | Practitioner - Nurse Practitioner | 6901135359 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220610 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Gila River Health Care Corporation | Current | Accepting new patients | |
| Rectiva Integrated Healthcare PLLC | Current | Accepting new patients | |
| Gila River Health Care Corporation | Current |
Accepting new patients | |
| Empire Health and Therapy LLC | Current |
Accepting new patients | |
| Empire Health and Therapy LLC | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Gila River Health Care | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current | Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Yadwinder S Dhillon MD PC | Nurse Practitioner | Past | Accepting new patients |
| Community Bridges, Inc. | Past |
Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Community Bridges, Inc. | Past |
Accepting new patients |
Locations
675 E Cottonwood Ln
Ste 140
Casa Grande, AZ 85122
Phone (520) 426-0088
358 E Javelina Ave
Ste 101
Mesa, AZ 85210
Phone (480) 507-3180
554 S Bellview
Rm B
Mesa, AZ 85204
Phone (480) 649-1141
1855 W Baseline Rd
Ste 101
Mesa, AZ 85202
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
1520 E Pima St
Phoenix, AZ 85034
Phone (480) 232-8325
3800 N Central Ave
Ste 460
Phoenix, AZ 85012
Phone (469) 466-7006
2770 E Van Buren St
Rm A
Phoenix, AZ 85008
Phone (602) 273-9999
2770 E Van Buren St
Rm Abd
Phoenix, AZ 85008
Phone (602) 273-9999
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- leloole.barikanp.p1@direct.cbridges.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 220610 | AZ | Yes |
Addresses
Primary practice location
103 Medicine Way Road
Peridot, AZ 85542-0787
Mailing address
PO Box 787
Peridot, AZ 85542-0787
Phone (928) 475-1274
Other practice location 1
1130 Bramlett Blvd
Lawrenceville, GA 30045-2359
Phone (678) 985-8412
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 546139 | Medicaid | AZ |
Other providers in Peridot, AZ
- Jade Lara Abudia
- Fabrice Afanyu-Lorater
- Dyanna Ah Quin
- Akdhc, LLC
- Julius Asofar Anumbosi
- Spencer Bigler
- Christopher Blair
- Mathew Michael Bull
- Judith-Ann Marie Chambers
- Lakota Cheek
All providers in Peridot, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.