Mrs Nicole Marie Riley, FNP in Tempe, AZ - Medicare Nurse Practitioner

Mrs Nicole Marie Riley, FNP is a medicare enrolled "Nurse Practitioner - Family" in Tempe, Arizona. Her current practice location is 1620 W Fountainhead Pkwy Ste 110, Tempe, Arizona. You can reach out to her office (for appointments etc.) via phone at (702) 600-1315.

Mrs Nicole Marie Riley is licensed to practice in Arizona (license number 294946) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639783210.

Contact Information

	Mrs Nicole Marie Riley, FNP
	1620 W Fountainhead Pkwy Ste 110, Tempe, AZ 85282-1946
	(702) 600-1315
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Nicole Marie Riley
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1620 W Fountainhead Pkwy Ste 110, Tempe, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639783210
Provider Enumeration Date: 09/01/2020
Last Update Date: 11/10/2025

Medicare PECOS Information:

PECOS PAC ID: 9234549577
Enrollment ID: I20201028000395

Medical Identifiers

Medical identifiers for Mrs Nicole Marie Riley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639783210	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	294946 (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. Mrs Nicole Marie Riley allows following entities to bill medicare on her behalf.

Entity Name	Jeaniene A Talley Md A Professional
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356528103 PECOS PAC ID: 8123102373 Enrollment ID: O20080226000692

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. Mrs Nicole Marie Riley 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
Mrs Nicole Marie Riley, FNP 2565 E Southern Ave Unit 67, Mesa, AZ 85204-5430 Ph: (702) 600-1315	Mrs Nicole Marie Riley, FNP 1620 W Fountainhead Pkwy Ste 110, Tempe, AZ 85282-1946 Ph: (702) 600-1315

Reviews and Comments

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Mrs Nicole Marie Riley, FNP - Medicare Nurse Practitioner in Tempe, AZ