Individual provider Active NPI

Andrew Altman

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1164207684
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221346 Issued in AZ
Practice address
19636 N 27TH Ave Ste 203
Phoenix, AZ 85027-4022
Phone
(623) 562-5050
NPI assigned
Aug 31, 2023
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 221346 AZ Primary
Registered Nurse 163W00000X 221346 AZ

Addresses

Primary practice location

19636 N 27TH Ave Ste 203
Phoenix, AZ 85027-4022

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240603002157 AZ Practitioner - Nurse Practitioner 4486196755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurosurgical Associates LTDGroup PAC ID 8820993967, 76 clinicians

Practice addresses (Care Compare)

19636 N 27TH Ave
Suite 203
Phoenix, AZ 85027-4022
Phone (623) 562-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221346AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates, LTD CurrentSince Jun 1, 2024 Accepting new patients
Neurosurgical Associates, LTD CurrentSince Jun 1, 2024 Accepting new patients

Locations

19636 N 27th Ave
Ste 203
Phoenix, AZ 85027
Phone (623) 562-3730

2910 N 3rd Ave
#200
Phoenix, AZ 85013
Phone (602) 406-3008

33300 N 32nd Ave
Ste 310
Phoenix, AZ 85085
Phone (602) 406-3181

Interoperability endpoints

  • Direct secure messaging: andrew.altman.1@31799.direct.athenahealth.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1164207684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE STE 203",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274022",
            "telephone_number": "623-562-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "221346",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "221346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.