Individual provider Active NPI

Amber Berleen, FNP

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1851890222
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11009 Issued in AZ
Practice address
5810 W Beverly LN
Glendale, AZ 85306-1800
Phone
(623) 312-3000
Fax
(623) 312-3060
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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 AP11009 AZ Primary

Addresses

Primary practice location

5810 W Beverly LN
Glendale, AZ 85306-1800

Mailing address

PO Box 6423
Chandler, AZ 85246-6423
Phone (480) 855-2224

Other identifiers 1

IdentifierTypeStateIssuer
369128MedicaidAZ

Other names 1

  • Amber Passmore Former name

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
I20180326000285 AZ Practitioner - Nurse Practitioner 6800158239 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
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

5810 W Beverly Lane
Glendale, AZ 85306-1800
Phone (623) 312-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP11009AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC CurrentSince Feb 19, 2018 Accepting new patients
Ironwood Physicians, PC CurrentSince Feb 19, 2018 Accepting new patients

Locations

13055 W McDowell Rd
Ste G112
Avondale, AZ 85392
Phone (623) 312-3020

5810 W Beverly Ln
Glendale, AZ 85306
Phone (623) 312-3000

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

14815 W Bell Rd
Ste 106
Surprise, AZ 85374
Phone (623) 312-3000

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1851890222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423",
            "telephone_number": "480-855-2224",
            "fax_number": "480-398-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 W BEVERLY LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061800",
            "telephone_number": "623-312-3000",
            "fax_number": "623-312-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLEEN",
        "first_name": "AMBER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369128",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PASSMORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.