Tamara Sue Rivenburgh-Casillas, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP0528 Issued in AZ

Practice address

1100 S. Dobson Rd
#223
Chandler, AZ 85286

Phone

(480) 821-8888

Fax

(480) 821-0888

NPI assigned

Nov 25, 2005

Last updated

Sep 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Tamara Sue Rivenburgh-Casillas Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Valley Dermatology CenterGroup PAC ID 8022093384, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.48 of 100Reported as group

Quality

88.21

Improvement activities

40

Cost

73.99

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDDGBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Valley Dermatology Center

  • Dermatology Physician
  • Chandler, AZ
  • NPI 1366529836
  Medicare reassignment Care Compare group NPD
• East Valley Dermatology RX, LLC

  • Non-Pharmacy Dispensing Site
  • Chandler, AZ
  • NPI 1013312925
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1134102965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8546 E GLENCOVE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852074111",
            "telephone_number": "480-980-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S. DOBSON RD",
            "address_2": "#223",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85286",
            "telephone_number": "480-821-8888",
            "fax_number": "480-821-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVENBURGH-CASILLAS",
        "first_name": "TAMARA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP0528",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0528",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "RIVENBURGH-CASILLAS",
            "middle_name": "SUE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Hannah Ritchie
• Patricia E Ritchie
• Rite Way Express Medical Trans
• Roberto Rivas
• Mariline Raquel Rivera Alvarado
• Olivia Rivera-Gutierrez
• Crystal Danielle Rivera
• Donna Lynn Rivera, APN, CNM
• Mary Margaret Rivera, FNP-BC

• Nurse Practitioner in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.