Individual provider Active NPI

Lukas Gardner

  • Acute Care Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1215745104
Registry record updated Jan 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
247536 Issued in AZ
Practice address
1851 N Gemini Dr
Flagstaff, AZ 86001-1607
Phone
(928) 547-2718
NPI assigned
Dec 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 247536 AZ Primary

Addresses

Primary practice location

1851 N Gemini Dr
Flagstaff, AZ 86001-1607

Mailing address

4343 E Soliere Ave Apt 2023
Flagstaff, AZ 86004-7953
Phone (913) 433-6299

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
I20251120000003 AZ Practitioner - Nurse Practitioner 1951891381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4343 E Soliere Ave Apt
Suite 2023
Flagstaff, AZ 86004-7953

PO Box
Suite 2510
Mesa, AZ 85214

Hospital & facility affiliations

  • Angels Care Home Health of Arizona No 5 Home health agency, Flagstaff, AZ, CCN 037500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247536AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Consultants PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1851 N Gemini Dr
Flagstaff, AZ 86001
Phone (928) 266-0118

3303 S Lindsay Rd
Ste 123
Gilbert, AZ 85297
Phone (480) 821-9339

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768694400000",
    "number": "1215745104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 E SOLIERE AVE APT 2023",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047953",
            "telephone_number": "913-433-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 N GEMINI DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011607",
            "telephone_number": "928-547-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LUKAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-23",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "247536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.