Individual provider Active NPI

Jacqueline Aragon Riley, FNP

  • Family Nurse Practitioner
  • Allen, TX
National Provider Identifier
1427395698
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144142 Issued in TX
Practice address
1774 W McDermott Dr Ste 150
Allen, TX 75013-3424
Phone
(469) 340-2777
Fax
(469) 208-0230
NPI assigned
Jan 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60226853 WA
Family Nurse Practitioner 363LF0000X AP144142 TX Primary

Addresses

Primary practice location

1774 W McDermott Dr Ste 150
Allen, TX 75013-3424

Mailing address

1774 W McDermott Dr Ste 150
Allen, TX 75013-3424
Phone (469) 340-2777

Other practice location 1

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 336-7300

Other identifiers 1

IdentifierTypeStateIssuer
0294713OtherLABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200921001579 TX Practitioner - Nurse Practitioner 1254693732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shahla Ali MD PAGroup PAC ID 4587971452, 25 clinicians

Practice addresses (Care Compare)

1774 W McDermott Dr
Suite 150
Allen, TX 75013-3424
Phone (469) 340-2777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shahla Ali MD PA CurrentSince Apr 20, 2021 Accepting new patients
Shahla Ali MD PA CurrentSince Aug 1, 2020 Accepting new patients

Locations

1774 W McDermott Dr
Ste 150
Allen, TX 75013
Phone (469) 340-2777

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.

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1427395698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 W MCDERMOTT DR STE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133424",
            "telephone_number": "469-340-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 W MCDERMOTT DR STE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133424",
            "telephone_number": "469-340-2777",
            "fax_number": "469-208-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 SE Bishop Blvd",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991635512",
            "country_code": "US",
            "telephone_number": "509-336-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARAGON RILEY",
        "first_name": "JACQUELINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60226853",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0294713",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.