Individual provider Active NPI

Diana Rivera, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1386488989
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
309165 Issued in AZ
Practice address
9515 W Camelback Rd Ste 118
Phoenix, AZ 85037-1365
Phone
(623) 322-7856
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 309165 AZ Primary

Addresses

Primary practice location

9515 W Camelback Rd Ste 118
Phoenix, AZ 85037-1365

Mailing address

12210 W Lincoln St
Avondale, AZ 85323-8412
Phone (602) 748-7093

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
I20250128000826 AZ Practitioner - Nurse Practitioner 0749719326 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309165AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All Family Care, PC CurrentSince Nov 23, 2024 Accepting new patients
Sonoran Pulmonary and Critical Care PLLC CurrentSince Jun 23, 2024 Accepting new patients
Healing Edge Recovery and Wellness Center CurrentSince Dec 26, 2024 Accepting new patients
Craig M. Rundbaken, D.O. PLLC CurrentSince Aug 26, 2024 Accepting new patients
Einfectionmd PC Past Accepting new patients

Locations

700 N Estrella Pkwy
Ste 120
Goodyear, AZ 85338
Phone (623) 299-9630

4220 N 20th Ave
Ste 100
Phoenix, AZ 85015
Phone (602) 254-9701

4120 N 108th Ave
Ste 116
Phoenix, AZ 85037
Phone (602) 881-5430

4220 N 20th Ave
Phoenix, AZ 85015
Phone (602) 279-7655

4120 N 108th Ave
#116
Phoenix, AZ 85037
Phone (623) 322-7856

9515 W Camelback Rd
Ste 118
Phoenix, AZ 85037
Phone (623) 322-7856

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1386488989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12210 W LINCOLN ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238412",
            "telephone_number": "602-748-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD STE 118",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371365",
            "telephone_number": "623-322-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DIANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "309165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.