Individual provider Active NPI

Troy Riutta, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1396237640
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP11328 Issued in AZ
Practice address
6151-6153 W Olive Ave
Glendale, AZ 85302-4598
Phone
(602) 685-6000
Fax
(602) 389-3599
NPI assigned
Jun 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP11328 AZ Primary

Addresses

Primary practice location

6151-6153 W Olive Ave
Glendale, AZ 85302-4598

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Other practice location 1

600 E. Hwy 260
Suite 9
Payson, AZ 85541
Phone (928) 363-1469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180709001666 AZ Practitioner - Nurse Practitioner 9032465869 Reassigns benefits to 1 organization
I20221108000644 CO Practitioner - Nurse Practitioner 9032465869

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Terros, Inc.Group PAC ID 8224077045, 26 clinicians

Practice addresses (Care Compare)

6151 -6153 W Olive Ave
Glendale, AZ 85302-4564
Phone (602) 389-3560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP11328AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terros, Inc. Current Accepting new patients
Terros Inc CurrentSince Jul 16, 2018 Accepting new patients
Ponderosa Family Care, LLC PastSince Jun 21, 2020 Accepting new patients
Ponderosa Family Care, LLC Past Accepting new patients

Locations

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEIBDA
  • Direct secure messaging: troy.riutta.p1@direct.terros.nextgenshare.com

Organizations & group practices 4

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": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1396237640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151-6153 W OLIVE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853024598",
            "telephone_number": "602-685-6000",
            "fax_number": "602-389-3599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 E. HWY 260",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "85541",
            "country_code": "US",
            "telephone_number": "928-363-1469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIUTTA",
        "first_name": "TROY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-02",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP11328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.