Amy Diane Carrillo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP144543 Issued in TX

Practice address

912 E 5TH St
Odessa, TX 79761-4605

Phone

(432) 334-8845

Fax

(432) 334-8875

NPI assigned

Jan 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scotty Ortega MD LLPGroup PAC ID 2567742943, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: a.carrillo@pedicare.directbygreenway.com

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.

• Scotty Ortega MD LLP

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1194015297
  Medicare reassignment Care Compare group NPD
• Amy Carrillo NP, PLLC

  • Primary Care Clinic/Center
  • Odessa, TX
  • NPI 1750062980
  NPD Authorized official
• Pedicare Childrens Clinic PA

  • Pediatrics Physician
  • Midland, TX
  • NPI 1255862074

  Family

  NPD (past)
• Pedicare Childrens Urgent Care PA

  • Urgent Care Clinic/Center
  • Corpus Christi, TX
  • NPI 1285165332
  NPD (past)
• Sing Dy Uy,MD Clinic PA

  • Clinic/Center
  • Odessa, TX
  • NPI 1023230265
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1366082075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 W HACIENDA DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797637208",
            "telephone_number": "432-770-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 E 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614605",
            "telephone_number": "432-334-8845",
            "fax_number": "432-334-8875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 N Midland Dr Ste 14A",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797075507",
            "country_code": "US",
            "telephone_number": "432-695-6300",
            "fax_number": "432-695-6571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "AMY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina Carrasco
• Matthew Daniel Carraway, DDS
• Carlo Kristian Chu Carredo, MD
• Lynnette Jewel Carrens, WHNP
• Elmer Wilfredo Carrillo Baro, MD
• Anna Marie Carrillo, LPC-S, RPT-S
• Bonnie C Carter, MD
• Tiffany Renee Carter, PA-C
• Diana Casanova, MD
• Helen Cass, RPH

• Family Nurse Practitioner in Odessa, TX
• Providers in Odessa, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.