Caroline Waceke Miya, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

223230 Issued in AZ

Practice address

11361 N 99TH Ave Ste 200
Peoria, AZ 85345-5470

Phone

(602) 650-1212

NPI assigned

Mar 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, OH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brightlife Behavioral Health LLCGroup PAC ID 3779014055, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brightlife Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1437841095
  Medicare reassignment Care Compare group NPD
• Mind 247 Practice LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1902472467
  Medicare reassignment NPD
• Starlight Wellness LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Peoria, AZ
  • NPI 1386306280
  NPD Authorized official
• Dr. Gregory Carr MD LLC

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1386041861
  Medicare reassignment
• Mind 247 Practice LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1659089951
  NPD
• Richlin Hightower Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Chandler, AZ
  • NPI 1619570728
  NPD (past)
• Recovery Innovations, Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1902776107
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1992266712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N 16TH ST STE 316",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061266",
            "telephone_number": "602-636-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11361 N 99TH AVE STE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455470",
            "telephone_number": "602-650-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYA",
        "first_name": "CAROLINE",
        "middle_name": "WACEKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN162403",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "223230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Missing Pieces.Org
• Jessica Mitchell, OTR/L
• Tiffany Nicole Mitchell, N.M.D.
• Ronald Joseph Mittel Jr., M.D.
• McKenzie Helene Mitton
• Radostin Iliev Mladenov, RDH
• MMC Doc MD LLC
• Modern Sports Medicine LLC
• Sonya M. Mody, M.D.
• Mohamed Khirfan PLLC

• Psychiatric/Mental Health Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.