Individual provider Active NPI

Nivedita Nandurkar, MD

  • Family Medicine Physician
  • Fountain Hills, AZ
National Provider Identifier
1083558530
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R82310 Issued in AZ
Practice address
16605 E Palisades Blvd Ste 150
Fountain Hills, AZ 85268-3717
Phone
(480) 837-4300
NPI assigned
Apr 15, 2026
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R82310 AZ Primary

Addresses

Primary practice location

16605 E Palisades Blvd Ste 150
Fountain Hills, AZ 85268-3717

Mailing address

12073 E Lupine Ave
Scottsdale, AZ 85259-3361
Phone (718) 902-5564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R82310AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Hospitalists PLC PastSince May 1, 2022 Accepting new patients
Primary Care Walk-in Medical Clinic Family Medicine PastSince Mar 1, 2015 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1083558530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12073 E LUPINE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593361",
            "telephone_number": "718-902-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16605 E PALISADES BLVD STE 150",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683717",
            "telephone_number": "480-837-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDURKAR",
        "first_name": "NIVEDITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R82310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.