THOMAS J PEMBERTON
NPI 1528600012
Registered Nurse - Psychiatric/Mental Health in Tempe, AZ

Q: What is Thomas Pemberton's NPI number?

The NPI number for Thomas Pemberton is 1528600012. It was assigned to this individual provider in the NPPES registry on October 16, 2019.

Q: What is Thomas Pemberton's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Psychiatric/Mental Health, with taxonomy code 163WP0808X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Pemberton was last updated on July 28, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 16, 2019PECOS EnrolledAccepts Medicare Assignment

618 S MADISON DR, TEMPE, AZ 85281(480) 784-1514 Get Directions Write a Review

NPPES record last updated: July 28, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 28, 2020, Oct 16, 2019 (2 updates tracked since 2019).

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About Thomas J Pemberton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS J PEMBERTON (NPI 1528600012) is an individual psychiatric/mental health provider in Tempe, Arizona, licensed in Arizona (RN196326) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1528600012

Entity TypeIndividualMale

Primary Taxonomy163WP0808X

Provider Legal NameTHOMAS J PEMBERTON

Location Address618 S MADISON DRTempe, AZ 85281-7248

Mailing Address11518 E Apache Trl Ste 129Apache Junction, AZ 85120-3572 · (480) 317-2214

Phone(480) 784-1514

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 16, 2019

Last NPPES UpdateJuly 28, 20202 updates tracked since enumeration

NPPES CertifiedJuly 28, 2020

✔ NPI 1528600012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental HealthNursing Service Providers

Taxonomy Code163WP0808X

License✔ Licensed in AZ · RN196326

618 S MADISON DR, Tempe, AZ 85281

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas J Pemberton is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335578822

PECOS Enrollment IDI20200403002904

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

56 services17 patients

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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA LARSON

Counselor (Mental Health)