Individual provider Active NPI

Stephanie Andrade

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1295248920
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007591 Issued in CA
Practice address
6486 Friars Rd Apt 104
San Diego, CA 92108-1029
Phone
(978) 604-6703
NPI assigned
Nov 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007591 CA Primary

Addresses

Primary practice location

6486 Friars Rd Apt 104
San Diego, CA 92108-1029

Mailing address

6486 Friars Rd Apt 104
San Diego, CA 92108-1029
Phone (978) 604-6703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, ME3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230811001751 MA Practitioner - Nurse Practitioner 5092073148 Reassigns benefits to 2 organizations
I20240723002292 NH Practitioner - Nurse Practitioner 5092073148 Reassigns benefits to 2 organizations
I20240806002405 ME Practitioner - Nurse Practitioner 5092073148 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
Robert Marriott Medical CorpGroup PAC ID 2567531494, 63 clinicians

Practice addresses (Care Compare)

88 Harbor Dr
Saco, ME 04072-2148
Phone (207) 283-3646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007591CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp CurrentSince Jul 1, 2024 Accepting new patients
Appledore Medical Group Dba Woodbury Family Practice CurrentSince Jun 30, 2024 Accepting new patients
Urgent Help Chelmsford PC CurrentSince Jun 28, 2023 Accepting new patients
Advantage Surgical and Wound Care Massachusetts PC CurrentSince Jun 1, 2024 Accepting new patients
Urgent Help Chelmsford PC Current Accepting new patients
Appledore Medical Group, Inc CurrentSince Jun 30, 2024 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

3232 Thunder Dr
Oceanside, CA 92056
Phone (760) 724-2193

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

199 Concord Rd
Billerica, MA 01821
Phone (781) 369-9876

45 Drum Hill Rd
Chelmsford, MA 01824
Phone (978) 446-7515

113 Low St
Newburyport, MA 01950
Phone (978) 462-7373

204 Proctor Ave
Revere, MA 02151
Phone (781) 286-3100

370 Portland St
Yarmouth, ME 04096
Phone (207) 846-9021

442 Main St
Fremont, NH 03044
Phone (603) 895-3126

25 New Hampshire Ave
Ste 100
Portsmouth, NH 03801
Phone (603) 431-2516

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1295248920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6486 FRIARS RD APT 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081029",
            "telephone_number": "978-604-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6486 FRIARS RD APT 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081029",
            "telephone_number": "978-604-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.