Individual provider Active NPI

Carisa Brein Miner, NP

  • Family Nurse Practitioner
  • Fountain Hills, AZ
National Provider Identifier
1821852559
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
248221 Issued in AZ
Practice address
13771 N Fountain Hills Blvd Ste 114-103
Fountain Hills, AZ 85268-3762
Phone
(888) 662-3376
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 248221 AZ Primary

Addresses

Primary practice location

13771 N Fountain Hills Blvd Ste 114-103
Fountain Hills, AZ 85268-3762

Mailing address

13771 N Fountain Hills Blvd Ste 114-103
Fountain Hills, AZ 85268-3762
Phone (888) 662-3376

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
I20241016001896 AZ Practitioner - Nurse Practitioner 7012449952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Dermright LLCGroup PAC ID 2567707060, 12 clinicians

Practice addresses (Care Compare)

Fountain Hills, AZ 85268
Phone (888) 662-3376

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermright LLC CurrentSince Aug 10, 2024 Accepting new patients

Locations

13771 N Fountain Hills Blvd
Ste 114303
Fountain Hills, AZ 85268

13771 N Fountain Hills Blvd
#114103
Fountain Hills, AZ 85268
Phone (888) 662-3376

13771 N Fountain Hills Blvd
Ste 114103
Fountain Hls, AZ 85268
Phone (480) 352-1608

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.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1821852559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13771 N FOUNTAIN HILLS BLVD STE 114-103",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683762",
            "telephone_number": "888-662-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13771 N FOUNTAIN HILLS BLVD STE 114-103",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683762",
            "telephone_number": "888-662-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "CARISA",
        "middle_name": "BREIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "248221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

Verify at the official NPI Registry.