Individual provider Active NPI

Carissa Noriega, FNP-C

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1154874790
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP8877 Issued in AZ
Practice address
10238 E Hampton Ave
#507
Mesa, AZ 85209-3316
Phone
(480) 821-3616
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP8877 AZ Primary

Addresses

Primary practice location

10238 E Hampton Ave
#507
Mesa, AZ 85209-3316

Mailing address

10238 E Hampton Ave
#507
Mesa, AZ 85209-3316
Phone (480) 821-3616

Other names 1

  • Mrs. Carissa Noriega Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160928001174 AZ Practitioner - Nurse Practitioner 9739476169 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP8877AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boojum Obstetrics and Gynecology CurrentSince Sep 25, 2023 Accepting new patients
Healthy Pregnancy Perinatology, LLC Past Accepting new patients

Locations

3367 S Mercy Rd
Ste 207
Gilbert, AZ 85297
Phone (480) 855-5900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1154874790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE",
            "address_2": "#507",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093316",
            "telephone_number": "480-821-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE",
            "address_2": "#507",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093316",
            "telephone_number": "480-821-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORIEGA",
        "first_name": "CARISSA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "NORIEGA",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.