Individual provider Active NPI

Lindsey Rae Wendel, CPNP-PC

  • Pediatric Nurse Practitioner
  • Boise, ID
National Provider Identifier
1023769882
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3771451 Issued in ID
Practice address
305 E Jefferson St
Boise, ID 83712-6231
Phone
(208) 381-7011
Fax
(208) 381-9013
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN.0997212-NP CO
Pediatric Nurse Practitioner 363LP0200X 0997212 CO
Pediatric Nurse Practitioner 363LP0200X 3771451 ID Primary

Addresses

Primary practice location

305 E Jefferson St
Boise, ID 83712-6231

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (303) 493-7000

Other practice location 2

9141 Grant St Ste 115
Thornton, CO 80229-4318
Phone (303) 920-9000

Other names 1

  • Lindsey Rae Elliott Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221216000642 CO Practitioner - Nurse Practitioner 3274902184 Reassigns benefits to 1 organization
I20251112001390 ID Practitioner - Nurse Practitioner 3274902184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0997212COMDPediatric Nurse Practitioner
3771451IDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 29, 2025 Accepting new patients
University Physicians Incorporated CurrentSince Jan 1, 2023 Accepting new patients
University Physicians Incorporated Nurse Practitioner Current Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Jan 1, 2023 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
Denver Pediatrics P.C. PastSince Jan 1, 2022 Accepting new patients

Locations

23770 E Smoky Hill Rd
Aurora, CO 80016
Phone (303) 812-2000

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

1811 Plaza Dr
Highlands Ranch, CO 80129
Phone (720) 478-0108

305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: lwendel58007@direct.childrenscolorado.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1023769882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126231",
            "telephone_number": "208-381-7011",
            "fax_number": "208-381-9013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "303-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9141 Grant St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802294318",
            "country_code": "US",
            "telephone_number": "303-920-9000",
            "fax_number": "303-920-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENDEL",
        "first_name": "LINDSEY",
        "middle_name": "RAE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0997212-NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "0997212",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "3771451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "ELLIOTT",
            "middle_name": "RAE",
            "credential": "CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.