Individual provider Active NPI

Lovejoy Tulusan Arriesgado, FNP-C

  • Family Medicine Physician
  • Surprise, AZ
National Provider Identifier
1861968794
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN218353 Issued in AZ
Practice address
14780 W Mountain View Blvd Ste 110
Surprise, AZ 85374-7280
Phone
(623) 374-7774
Fax
(855) 420-6361
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 218353 AZ
Family Medicine Physician 207Q00000X APRN218353 AZ Primary

Addresses

Primary practice location

14780 W Mountain View Blvd Ste 110
Surprise, AZ 85374-7280

Mailing address

14780 W Mountain View Blvd Ste 110
Surprise, AZ 85374-7280
Phone (602) 374-7774

Other practice location 1

1041 E Meadow Ln
Phoenix, AZ 85022-4334
Phone (602) 774-4234

Other identifiers 1

IdentifierTypeStateIssuer
218353OtherAZAPRN-RNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN218353AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Clinic LLC Current Accepting new patients

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1861968794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "602-374-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-374-7774",
            "fax_number": "855-420-6361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1041 E Meadow Ln",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850224334",
            "country_code": "US",
            "telephone_number": "602-774-4234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARRIESGADO",
        "first_name": "LOVEJOY",
        "middle_name": "TULUSAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "218353",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "APRN218353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN-RNP",
            "identifier": "218353",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.