Charles C De La Riva Jr, NP-C - Medicare Nurse Practitioner in Phoenix, AZ

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Charles C De La Riva Jr, NP-C is a medicare enrolled "Nurse Practitioner" in Phoenix, Arizona. He graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. His current practice location is 202 E Earll Dr Ste 360, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 788-5621.

Charles C De La Riva Jr is licensed to practice in Arizona (license number 261707) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336726447.

Contact Information

Charles C De La Riva Jr, NP-C
202 E Earll Dr Ste 360,
Phoenix, AZ 85012-2677
(480) 788-5621
(480) 779-1277

Map and Direction




Provider's Profile

Full NameCharles C De La Riva Jr
GenderMale
SpecialityNurse Practitioner
Experience3 Years
Location202 E Earll Dr Ste 360, Phoenix, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Charles C De La Riva Jr graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1336726447
  • Provider Enumeration Date: 03/25/2021
  • Last Update Date: 09/15/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0244636777
  • Enrollment ID: I20210909001029

Medical Identifiers

Medical identifiers for Charles C De La Riva Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336726447NPI-NPPES
261707OtherAZNURSE PRACTITIONER
192810OtherAZREGISTERED NURSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 192810 (Arizona)Secondary
163W00000XRegistered Nurse 261707 (Arizona)Secondary
363LF0000XNurse Practitioner - Family 261707 (Arizona)Secondary
363L00000XNurse Practitioner 261707 (Arizona)Primary

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. Charles C De La Riva Jr allows following entities to bill medicare on his behalf.
Entity NameLifewell Behavioral Wellness
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417050337
PECOS PAC ID: 4981641818
Enrollment ID: O20050412001535
Entity NameSouthwest Integrated Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861985798
PECOS PAC ID: 2466704481
Enrollment ID: O20181002002679
Entity NameEstrella Family Care And Aesthetics Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912666868
PECOS PAC ID: 6800282880
Enrollment ID: O20220330001805

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. Charles C De La Riva Jr 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 AddressPractice Location Address
Charles C De La Riva Jr, NP-C
202 E Earll Dr Ste 360,
Phoenix, AZ 85012-2677

Ph: (480) 788-5621		Charles C De La Riva Jr, NP-C
202 E Earll Dr Ste 360,
Phoenix, AZ 85012-2677

Ph: (480) 788-5621

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.