Derek Sebade, ANPC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN082334 Issued in AZ

Practice address

20040 N 19TH Ave
Suite a
Phoenix, AZ 85027-4255

Phone

(623) 869-5000

Fax

(623) 869-0927

NPI assigned

Aug 4, 2005

Reactivated

Mar 27, 2006

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Greater Phoenix Collaborative Care PC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1750686614
  NPD (past)
• Radiant Hills Health Associates LLC

  • Skilled Nursing Facility
  • Phoenix, AZ
  • NPI 1053306811
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1376544924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20040 N 19TH AVE",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274255",
            "telephone_number": "623-869-5000",
            "fax_number": "623-869-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20040 N 19TH AVE",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274255",
            "telephone_number": "623-869-5000",
            "fax_number": "623-869-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBADE",
        "first_name": "DEREK",
        "credential": "ANPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2012-12-21",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN082334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61944",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Charles Seaton, PH.D.
• Genita Seaton, COTA
• Jennifer Seaton, RN
• Linda Edith Seaver, MD
• Brantley Allen Seawright, DPT
• Jessica Sebastian
• Linnet Sebastian, AG ACNP-BC
• Danielle Kathlyn Sebbens, CRNP
• Aron Mekonen Sebhat, MD, MPH
• Erin Sebree, LICDC

• Adult Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.