Individual provider Active NPI

Teresa Loera, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1336614858
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11478 Issued in AZ
Practice address
3201 W Peoria Ave
A105
Phoenix, AZ 85029-4609
Phone
(602) 918-3225
Fax
(833) 992-2059
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN157495 AZ
Family Nurse Practitioner 363LF0000X AP11478 AZ Primary

Addresses

Primary practice location

3201 W Peoria Ave
A105
Phoenix, AZ 85029-4609

Mailing address

3201 W Peoria Ave
A105
Phoenix, AZ 85029-4069
Phone (602) 918-3225

Other identifiers 3

IdentifierTypeStateIssuer
545062MedicaidAZ
AP11478OtherAZCERTIFIED NURSE PRACTITIONER
F06182018OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

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
I20190814001941 AZ Practitioner - Nurse Practitioner 9436486438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TL Family Nurse Practice LLCGroup PAC ID 4880013846, 5 clinicians

Practice addresses (Care Compare)

3201 W Peoria Ave
Suite A105
Phoenix, AZ 85029-4609
Phone (602) 918-3225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN157495AZMDRegistered Nurse
AP11478AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TL Family Nurse Practice LLC Current Accepting new patients
District Medical Group, Inc CurrentSince Jun 1, 2019 Accepting new patients
TL Family Nurse Practice LLC CurrentSince Jun 17, 2020 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Jun 1, 2019 Accepting new patients

Locations

13055 W McDowell Rd
Ste E101
Avondale, AZ 85392
Phone (480) 515-0900

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

3201 W Peoria Ave
Ste A105
Phoenix, AZ 85029
Phone (602) 841-9720

4150 W Peoria Ave
Ste 122
Phoenix, AZ 85029
Phone (602) 918-3225

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21538/brand/1/csg/1/fhir/r4
  • Direct secure messaging: teresa.loera.1@21538.direct.athenahealth.com
  • Direct secure messaging: teresa.loera.1@17515.direct.athenahealth.com

Organizations & group practices 5

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1336614858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "A105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294069",
            "telephone_number": "602-918-3225",
            "fax_number": "833-992-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "A105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294609",
            "telephone_number": "602-918-3225",
            "fax_number": "833-992-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOERA",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN157495",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545062",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER",
            "identifier": "AP11478",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F06182018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.