Nathan Vandegraaff

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9728 Issued in AZ

Practice address

9520 W Palm LN Ste 150
Phoenix, AZ 85037-4454

Phone

(602) 584-5444

Fax

(602) 584-6202

NPI assigned

Jul 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Midwestern University College of Dental Medicine, Glendale, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart One Associates LLCGroup PAC ID 0446585897, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Heart One Associates LLC

  • Cardiovascular Disease Physician
  • Phoenix, AZ
  • NPI 1942778766
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1215614037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 W PALM LN STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374454",
            "telephone_number": "602-584-5444",
            "fax_number": "602-584-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 W PALM LN STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374454",
            "telephone_number": "602-584-5444",
            "fax_number": "602-584-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEGRAAFF",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Detra L Vance
• Hillary Kristi Vance, PT, DPT
• Luz Elena Vance
• Marceline Vance, CCC-SLP
• Stephanie Vancott, RN
• David Cooper Vandemerwe, DO
• Kasey Lynn Vanden Bosch, DO
• Stephanie K Vanden Bosch, C.R.N.A.
• Sharon R Vandenberg
• Catherine Vanderaa

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.