Individual provider Active NPI

Adalivia Resendiz-Casas, DNP

  • Gerontology Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1902462856
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
228828 Issued in AZ
Practice address
10815 W McDowell Rd Ste 305
Avondale, AZ 85392-5016
Phone
(480) 840-1754
Fax
(480) 840-1764
NPI assigned
May 16, 2019
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 228828 AZ Primary
Registered Nurse 163W00000X RN170174 AZ

Addresses

Primary practice location

10815 W McDowell Rd Ste 305
Avondale, AZ 85392-5016

Mailing address

3815 E Bell Rd Ste 2200
Phoenix, AZ 85032-2139
Phone (602) 633-3848

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
I20190905002836 AZ Practitioner - Nurse Practitioner 0547599276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN170174AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Jul 15, 2022 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Jul 15, 2022 Accepting new patients

Locations

207 N Gilbert Rd
Ste 208
Gilbert, AZ 85234
Phone (480) 827-5800

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1902462856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322139",
            "telephone_number": "602-633-3848",
            "fax_number": "602-633-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD STE 305",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925016",
            "telephone_number": "480-840-1754",
            "fax_number": "480-840-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESENDIZ-CASAS",
        "first_name": "ADALIVIA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "228828",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN170174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.