CARLY ELIZABETH COELHO — NPI 1023689874 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered in RIVERDALE, CA)

CMS-1500 Box 24J / 33a • NPI

1023689874

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

367500000X (CMS 43)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered

Box 32 Service Location & ZIP+4

3281 W TIGER AVE, RIVERDALE, CA, 93656-9763

✓ 9-Digit EDI 837 ZIP+4 (93656-9763)

Practice Phone & Referral Fax

(480) 478-5502

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1023689874 (CARLY ELIZABETH COELHO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1023689874` (NPI-1 Individual Practitioner)
Provider / Legal Name	CARLY ELIZABETH COELHO
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: `367500000X` (Nurse Anesthetist, Certified Registered)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3281 W TIGER AVE, RIVERDALE, CA, 93656-9763
Practice Telephone / Fax	Tel: (480) 478-5502
Administrative Mailing Address	3281 W TIGER AVE, RIVERDALE, CA, 93656-9763
Enumeration & Last Sync	Enumerated: 2021-07-02 \| CMS Record Updated: 2023-02-03

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3281 W TIGER AVE, RIVERDALE, CA, 93656-9763

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Plain-English Taxonomy & CMS Crosswalk (367500000X)

What Does Taxonomy Code 367500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 43 (Certified Registered Nurse Anesthetist (CRNA))
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Anesthetist, Certified Registered for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CARLY ELIZABETH COELHO)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163W00000X` — Registered Nurse Plain English: Licensed & Credentialed Registered Nurse	State: CA \| License: `95109836` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: CA \| License: `NA95001972` \| Primary: Yes (Primary)

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CARLY ELIZABETH COELHO (NPI #1023689874)