Individual provider Active NPI

Tristan Rico, NP

  • Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1851908800
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
222151 Issued in AZ
Practice address
10815 W McDowell Rd Ste 202
Avondale, AZ 85392-5010
Phone
(623) 433-0202
NPI assigned
Sep 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 222151 AZ Primary

Addresses

Primary practice location

10815 W McDowell Rd Ste 202
Avondale, AZ 85392-5010

Mailing address

3815 E Bell Rd Ste 4500
Phoenix, AZ 85032-2171
Phone (602) 633-6848

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
I20250103001196 AZ Practitioner - Nurse Practitioner 5991233991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Arizona, LLCGroup PAC ID 1052328408, 94 clinicians

Practice addresses (Care Compare)

10815 W McDowell Rd
Suite 202
Avondale, AZ 85392-5010
Phone (623) 433-0202

Hospital & facility affiliations

  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Arizona, LLC Current Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince Dec 30, 2024 Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince Dec 30, 2024 Accepting new patients

Locations

10815 W McDowell Rd
Ste 202
Avondale, AZ 85392

10815 W McDowell Rd
Ste 20220
Avondale, AZ 85392

10815 W McDowell Rd
Ste 2
Avondale, AZ 85392

10815 W McDowell Rd
Ste 304
Avondale, AZ 85392
Phone (623) 433-0155

14415 W McDowell Rd
Ste D102
Goodyear, AZ 85395
Phone (623) 512-4190

111 W Cedar Ln
Ste A
Payson, AZ 85541
Phone (928) 472-4675

1301 S 7th Ave
Ste 400
Phoenix, AZ 85007
Phone (602) 824-3358

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

3540 E Baseline Rd
Ste 131
Phoenix, AZ 85042
Phone (480) 634-1232

6036 N 19th Ave
Ste 510
Phoenix, AZ 85015
Phone (602) 246-3223

16928 W Bell Rd
Ste 702
Surprise, AZ 85374

Interoperability endpoints

  • Direct secure messaging: tristan.rico.2@33227.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1851908800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322171",
            "telephone_number": "602-633-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD STE 202",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925010",
            "telephone_number": "623-433-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICO",
        "first_name": "TRISTAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "222151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.