Individual provider Active NPI

Danielle Carrillo, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1366992802
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP9011 Issued in AZ
Practice address
6020 E Arbor Ave
Suite 101
Mesa, AZ 85206
Phone
(480) 985-1700
Fax
(480) 396-3659
NPI assigned
Oct 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP9011 AZ Primary

Addresses

Primary practice location

6020 E Arbor Ave
Suite 101
Mesa, AZ 85206

Mailing address

3020 E Camelback Rd
Suite 301
Phoenix, AZ 85016-7441
Phone (602) 264-9100

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
I20161025001274 AZ Practitioner - Nurse Practitioner 6103104237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Digestive Health PCGroup PAC ID 6507940731, 134 clinicians

Practice addresses (Care Compare)

13640 N 99TH Ave
Suite 600
Sun City, AZ 85351-2867
Phone (623) 972-2116

Hospital & facility affiliations

  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Merit-based Incentive Payment System (MIPS)

Final score
81.75 of 100Reported as group
Quality
60.45
Promoting interoperability
97
Improvement activities
40
Cost
81.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP9011AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Digestive Health, PC CurrentSince Oct 10, 2016 Accepting new patients
Az Care Anesthesia , PLC CurrentSince Oct 10, 2016 Accepting new patients

Locations

5823 W Eugie Ave
Ste A
Glendale, AZ 85304
Phone (602) 439-1717

6020 E Arbor Ave
Ste 101
Mesa, AZ 85206
Phone (480) 985-1700

9836 W Yearling Rd
Unit 1300
Peoria, AZ 85383
Phone (623) 972-2116

3020 E Camelback Rd
Ste 301
Phoenix, AZ 85016

13640 N 99th Ave
Ste 600
Sun City, AZ 85351
Phone (623) 523-0580

14869 W Bell Rd
Ste 100
Surprise, AZ 85374
Phone (623) 972-2116

519 Rose Ln
Wickenburg, AZ 85390
Phone (844) 888-0408

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1366992802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E CAMELBACK RD",
            "address_2": "SUITE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167441",
            "telephone_number": "602-264-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 E ARBOR AVE",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-985-1700",
            "fax_number": "480-396-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "DANIELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-08",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.