Individual provider Active NPI

Alyssa Ridao

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1740902931
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
280770 Issued in AZ
Practice address
500 W Thomas Rd Ste 100
Phoenix, AZ 85013-4255
Phone
(602) 406-1510
NPI assigned
Sep 14, 2022
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 280770 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 100
Phoenix, AZ 85013-4255

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

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
I20221223000001 AZ Practitioner - Nurse Practitioner 2365812997 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280770AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Institute of Arizona PLLC CurrentSince Aug 1, 2025 Accepting new patients
Terros, Inc CurrentSince Sep 1, 2025 Accepting new patients
Terros Inc CurrentSince Sep 1, 2025 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Sep 20, 2025 Accepting new patients
Terros, Inc. Current Accepting new patients
Terros, Inc. Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

3011 S Lindsay Rd
Bldg 6
Gilbert, AZ 85295
Phone (602) 249-8578

40 E Mitchell Dr
Ste 100
Phoenix, AZ 85012
Phone (602) 995-7474

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

500 W Thomas Rd
Ste 100
Phoenix, AZ 85013
Phone (602) 406-1115

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: alyssa.ridao.p1@direct.terros.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1740902931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134255",
            "telephone_number": "602-406-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDAO",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "280770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.