Individual provider Active NPI

Nathan Liebenstein, ARNP

  • Adult Health Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1235657586
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
256160 Issued in AZ
Practice address
3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone
(928) 771-3704
Fax
(928) 771-0434
NPI assigned
Sep 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 256160 AZ Primary

Addresses

Primary practice location

3120 Clearwater Dr
Prescott, AZ 86305-7131

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
093322MedicaidAZ

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
I20210714001847 AZ Practitioner - Nurse Practitioner 1153689658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

802 Ainsworth Dr
Suite B
Prescott, AZ 86301-1623
Phone (928) 445-1232

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Aug 16, 2021 Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

802 Ainsworth Dr
Ste B
Prescott, AZ 86301
Phone (928) 445-1232

1001 Willow Creek Rd
Ste 2200
Prescott, AZ 86301
Phone (928) 445-6025

802 Ainsworth Dr
Ste A
Prescott, AZ 86301
Phone (928) 445-6025

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

Interoperability endpoints

  • Direct secure messaging: nliebenstein181150@ghc.direct-ci.net

Organizations & group practices 3

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 4

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": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1235657586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 CLEARWATER DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057131",
            "telephone_number": "928-771-3704",
            "fax_number": "928-771-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBENSTEIN",
        "first_name": "NATHAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "256160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093322",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.