Individual provider Active NPI

Lindsey Rae Andrade, FNP-BC

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1447776505
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
289753 Issued in AZ
Practice address
20401 N 73Rd St Ste 230
Scottsdale, AZ 85255-4153
Phone
(480) 556-0446
NPI assigned
Aug 20, 2017
Reactivated
May 26, 2023
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 289753 AZ Primary
Registered Nurse 163W00000X 95075469 CA
Registered Nurse 163W00000X RN90196 NV
Registered Nurse 163W00000X RN159404 AZ

Addresses

Primary practice location

20401 N 73Rd St Ste 230
Scottsdale, AZ 85255-4153

Mailing address

12975 N 149TH Dr
Surprise, AZ 85379-6903
Phone (702) 525-8312

Other identifiers 1

IdentifierTypeStateIssuer
D01782280OtherAZDRIVERS LICENSE

Other names 1

  • Lindsey Rae Maniates Former name

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
I20230607003323 AZ Practitioner - Nurse Practitioner 9638536592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Lee Averitte Jr PLLCGroup PAC ID 9638069099, 31 clinicians

Practice addresses (Care Compare)

13995 W Statler Blvd
Suite 150
Surprise, AZ 85374-5512
Phone (480) 556-0446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95075469CAMDRegistered Nurse
RN90196NVMDRegistered Nurse
289753AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Lee Averitte Jr PLLC CurrentSince May 1, 2023 Accepting new patients
Richard Lee Averitte Jr., PLLC PastSince May 1, 2023 Accepting new patients

Locations

9520 W Palm Ln
Ste 115
Phoenix, AZ 85037

20401 N 73rd St
Ste 230
Scottsdale, AZ 85255

13995 W Statler Blvd
Ste 150
Surprise, AZ 85374
Phone (480) 223-6843

Interoperability endpoints

  • Direct secure messaging: landrade@affderm.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1447776505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12975 N 149TH DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796903",
            "telephone_number": "702-525-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST STE 230",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554153",
            "telephone_number": "480-556-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "LINDSEY",
        "middle_name": "RAE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-20",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "deactivation_date": "2023-04-20",
        "reactivation_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "289753",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95075469",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN90196",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN159404",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "D01782280",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "MANIATES",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.