Individual provider Active NPI

Alyssa Emily Lewellen

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1336635937
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11431 Issued in AZ
Practice address
6611 W Bell Rd
Glendale, AZ 85308-3607
Phone
(000) 000-0000
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 AP11431 AZ Primary

Addresses

Primary practice location

6611 W Bell Rd
Glendale, AZ 85308-3607

Mailing address

7952 N 43Rd Ave
Glendale, AZ 85301-1662
Phone (623) 465-6330

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
I20181030001778 AZ Practitioner - Nurse Practitioner 6204189749 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rajiv Siddaramu MD PLLCGroup PAC ID 9638480593, 10 clinicians

Practice addresses (Care Compare)

4742 N 24TH St
Suite 300
Phoenix, AZ 85016-9107
Phone (918) 977-1830

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP11431AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Siddaramu MD PLLC CurrentSince Apr 2, 2025 Accepting new patients
Hospice of the Valley CurrentSince Oct 20, 2023 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Sep 1, 2018 Accepting new patients
Hospice of the Valley CurrentSince Oct 20, 2023 Accepting new patients
Geriatric Solutions - Hov, LLC CurrentSince Aug 15, 2022 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Sep 1, 2018 Accepting new patients

Locations

4742 N 24th St
Phoenix, AZ 85016
Phone (480) 508-2555

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

1510 E Flower St
Phoenix, AZ 85014
Phone (602) 530-6900

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

4742 N 24th St
Ste 300
Phoenix, AZ 85016
Phone (480) 522-2046

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3219 E Camelback Rd
Phoenix, AZ 85018
Phone (480) 561-6185

9700 N 91st St
Ste A115
Scottsdale, AZ 85258
Phone (480) 922-1376

436 E Southern Ave
Tempe, AZ 85282
Phone (480) 336-2039

Organizations & group practices 7

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 3

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1336635937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7952 N 43RD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011662",
            "telephone_number": "623-465-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083607",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWELLEN",
        "first_name": "ALYSSA",
        "middle_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.