Charles C De la Riva Jr., NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

261707 Issued in AZ

Practice address

202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677

Phone

(480) 788-5621

Fax

(480) 779-1277

NPI assigned

Mar 25, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

I Am Wellness Az LLCGroup PAC ID 8123497344, 35 clinicians

Progressive Pain Management IncGroup PAC ID 1153490727, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 37)

Interoperability endpoints

• Direct secure messaging: charles.de.la.riva.1@25268.direct.athenahealth.com
• Direct secure messaging: charles.delarivafnp.p1@direct.nextcare.nextgenshare.com
• Direct secure messaging: charles.delarivafnp.p1@direct.lifewell.nextgenshare.com
• FHIR API: https://api.platform.athenahealth.com/25268/brand/1/csg/1/fhir/r4

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.

• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  Medicare reassignment Care Compare group NPD
• I Am Wellness Az LLC

  • Adult Medicine Physician
  • Chandler, AZ
  • NPI 1184354532
  Medicare reassignment Care Compare group
• Progressive Pain Management Inc

  • Interventional Pain Medicine Physician
  • Casa Grande, AZ
  • NPI 1881866754
  Medicare reassignment Care Compare group
• Estrella Family Care and Aesthetics LLC

  • Family Nurse Practitioner
  • Goodyear, AZ
  • NPI 1912666868
  Medicare reassignment NPD
• Lifewell Behavioral Wellness

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1417050337
  Medicare reassignment NPD
• Nextcare Arizona LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment NPD
• Southwest Integrated Health LLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1861985798
  Medicare reassignment NPD
• Hope Diabetes Center, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1104865757
  Medicare reassignment NPD (past)
• Advanced Minimally Invasive Surgical

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1295056919
  Medicare reassignment
• Maria Gonzalez Berlari, MD LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1699025981
  Medicare reassignment
• Michael F Esber DPM PC

  • Foot Surgery Podiatrist
  • Sun City West, AZ
  • NPI 1902907504
  Medicare reassignment
• Chandler Urgent Care LLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1881650471
  NPD (past)

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1336726447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 360",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122677",
            "telephone_number": "480-788-5621",
            "fax_number": "480-779-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 360",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122677",
            "telephone_number": "480-788-5621",
            "fax_number": "480-779-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA RIVA",
        "first_name": "CHARLES",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "192810",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "261707",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "261707",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "261707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "261707",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "192810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie De la Cruz
• Venessa B De la Cruz, L.C.S.W
• Anna De la Huerta
• Mark Charles De la Lama, PA-C
• Dwayne Paul De la Pena, LMSW
• Diana Belinda De la Rosa, LPC
• Humberto Enrique De la Torre Hogan
• Martha L De la Torre, LAC
• Rodrigo De la Torre
• Ana Alicia De la Vega

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, 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 15, 2021; 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.