Individual provider Active NPI

Katelyn Tolentino Tamaray, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1457079105
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
279563 Issued in AZ
Practice address
6950 E Golf Links Rd
Tucson, AZ 85730-1017
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 279563 AZ Primary

Addresses

Primary practice location

6950 E Golf Links Rd
Tucson, AZ 85730-1017

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

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
I20221103002159 AZ Practitioner - Nurse Practitioner 1951778935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Rio Santa Cruz Neighborhood Health Center, Inc.Group PAC ID 6305739244, 283 clinicians

Practice addresses (Care Compare)

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279563AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Aug 29, 2022 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Aug 29, 2022 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients

Locations

4550 S Palo Verde Rd
Bldg 1
Tucson, AZ 85714

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

1230 S Cherrybell Stra
Tucson, AZ 85713
Phone (520) 310-7316

6950 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 309-3250

101 W Irvington Rd
Bldg 3C
Tucson, AZ 85714
Phone (520) 573-0096

3655 E Grant Rd
Tucson, AZ 85716
Phone (520) 440-6323

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1457079105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 E GOLF LINKS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857301017",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMARAY",
        "first_name": "KATELYN",
        "middle_name": "TOLENTINO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.