Eric Jacob Hendrik Van Der Lelij

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9944 Issued in AZ

Practice address

1669 W Ina Rd Ste 101
Tucson, AZ 85704-1976

Phone

(520) 795-6183

NPI assigned

Mar 2, 2017

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

NM Pacs 2 LLCGroup PAC ID 3375892060, 108 clinicians

Arizona Post-Acute Medical Services 1 PCGroup PAC ID 4688951239, 18 clinicians

CS Pacs 3 West LLCGroup PAC ID 8921546797, 12 clinicians

Arizona Acute Medical Services 1 PCGroup PAC ID 6204113970, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evanderlelij114612@westdirect.optum.com

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.

• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674

  AZ

  Medicare reassignment Care Compare group NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419

  AZ

  Medicare reassignment Care Compare group NPD
• CS Pacs 3 West LLC

  • Hospitalist Physician
  • Sunnyvale, CA
  • NPI 1073378238

  AZ

  Medicare reassignment Care Compare group NPD
• NM Pacs 2 LLC

  • Hospitalist Physician
  • Albuquerque, NM
  • NPI 1366928749

  AZ

  Medicare reassignment Care Compare group NPD
• Greater Phoenix Collaborative Care PC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1750686614

  AZ

  Medicare reassignment NPD
• Arizona Medical Services, PC

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1679583306
  NPD
• Greater Phoenix Collaborative Care PC

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1790581742
  NPD

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1265972715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "520-795-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 W INA RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041976",
            "telephone_number": "520-795-6183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3945 E Paradise Falls Dr",
            "address_2": "#201",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857126683",
            "country_code": "US",
            "telephone_number": "520-290-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER LELIJ",
        "first_name": "ERIC",
        "middle_name": "JACOB HENDRIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-02",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Van Alsburg-Stropka
• Ashley Van Bodegon, MSW
• Jami Amanda Van Brocklin, APRN, PMHNP-BC
• Sarah Elisabeth Van Burken
• Joseph G. Van Cleve, D.D.S.
• Jule Layne Van Der Merwe, MD
• Martha Van Der Voort, LPC
• Martha Elizabeth Van Driel, FNP-C
• Britta Van Dun, L.AC., M.S., ED.M
• Mark Anthony Van Dyke, LCSW

• All providers in Tucson, AZ
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.