Individual provider Active NPI

Leena R Tarin, NP

  • Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1194289280
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
219162 Issued in AZ
Practice address
18509 E Apricot LN
Queen Creek, AZ 85142-3529
Phone
(480) 203-9664
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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 219162 AZ Primary

Addresses

Primary practice location

18509 E Apricot LN
Queen Creek, AZ 85142-3529

Mailing address

18509 E Apricot LN
Queen Creek, AZ 85142-3529
Phone (480) 203-9664

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
I20200512000655 AZ Practitioner - Nurse Practitioner 3577994383 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Services Arizona-Private, LLC CurrentSince Nov 22, 2019 Accepting new patients
Minghsun Liu, MD PC CurrentSince May 1, 2020 Accepting new patients
Community Medical Services Arizona-Private, LLC Past Accepting new patients
Community Medical Services Arizona-Private, LLC PastSince Feb 1, 2021 Accepting new patients

Locations

41810 N Venture Dr
Ste E152
Anthem, AZ 85086
Phone (623) 584-9295

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

Organizations & group practices 4

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1194289280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18509 E APRICOT LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423529",
            "telephone_number": "480-203-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18509 E APRICOT LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423529",
            "telephone_number": "480-203-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIN",
        "first_name": "LEENA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "219162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.