Tara Arocho, NP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Chubbuck, ID

NPI 1649952953 · NPPES record last updated Aug 4, 2023

Key facts

NPI
1649952953
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
58704 (ID)
Practice address
4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone
(208) 252-5621
NPI assigned
Aug 4, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Canvi Behavioral Health PLLC (14 clinicians)

Practice addresses (Care Compare)

4650 Hawthorne Rd
Suite 3B
Chubbuck, ID 83202-2376
Phone (208) 252-5621

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231002001924 ID Practitioner - Nurse Practitioner 9830543354 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canvi Behavioral Health PLLC Psychiatric/Mental Health Current
since Aug 21, 2023
Accepting new patients

Locations

4650 Hawthorne Rd
Ste 3B
Pocatello, ID 83202
Phone (208) 237-9833

1120 Stocks Ave
Ste B
Rexburg, ID 83440

407 W 1st N
Rexburg, ID 83440
Phone (208) 356-6555

600 Shanafelt St
Salmon, ID 83467
Phone (208) 756-8391

476 Heritage Park Blvd
Ste 230
Layton, UT 84041
Phone (801) 896-5345

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 58704 ID Yes

Addresses

Primary practice location

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Mailing address

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone (208) 252-5621

Other providers in Chubbuck, ID

All providers in Chubbuck, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho

Sources for this page

Verify at the official NPI Registry.