Kelly Carrillo, CRNA is a medicare enrolled "Registered Nurse" physician in Tucson, Arizona. She graduated from medical school in 2021 and has 3 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Ias Arizona Pllc, Banner -- University Medical Group and her current practice location is
1625 N Campbell Ave, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 792-1450.
Kelly Carrillo is licensed to practice in Arizona (license number RN176261) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063806214.
Physician's Profile
| Full Name | Kelly Carrillo |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 3 Years |
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| Location | 1625 N Campbell Ave, Tucson, Arizona |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly Carrillo graduated from medical school in 2021
NPI Data:
- NPI Number: 1063806214
- Provider Enumeration Date: 03/26/2015
- Last Update Date: 03/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537563309
- Enrollment ID: I20210802003157
Medical Identifiers
Medical identifiers for Kelly Carrillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063806214 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | 261429 (Arizona) | Secondary |
| 163W00000X | Registered Nurse | RN176261 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Ias Arizona Pllc | 7517312648 | 137 |
| Banner -- University Medical Group | 7719899871 | 817 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Carrillo allows following entities to bill medicare on her behalf.
| Entity Name | Banner -- University Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508809427
PECOS PAC ID: 7719899871
Enrollment ID: O20031105000694 |
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| Entity Name | B--umg Tucson Ap Physicians Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487178505
PECOS PAC ID: 1355616517
Enrollment ID: O20171013002780 |
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| Entity Name | Ias Arizona Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689359747
PECOS PAC ID: 7517312648
Enrollment ID: O20231010003129 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Carrillo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Carrillo, CRNA
4237 E Kilmer St,
Tucson, AZ 85711-2825
Ph: (520) 539-8905 | Kelly Carrillo, CRNA
1625 N Campbell Ave,
Tucson, AZ 85719-4330
Ph: (520) 792-1450 |
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