Sandra Lerdal, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG11210010 Issued in AZ

Practice address

13236 N 26TH PL
Phoenix, AZ 85032-5903

Phone

(605) 929-7253

NPI assigned

Nov 30, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sandra Wipf Former name

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Corner Health Medical Group P aGroup PAC ID 5799223236, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Corner Health Medical Group P a

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1205689171
  Medicare reassignment Care Compare group NPD
• Renew Medical Center, LLC

  • Physical Medicine & Rehabilitation Physician
  • Glendale, AZ
  • NPI 1043800345
  Medicare reassignment NPD
• Advanced Technology Chiropractic LLC

  • Chiropractor
  • Glendale, AZ
  • NPI 1336497643
  NPD (past)
• Travis Optometry LLC

  • Clinic/Center
  • Scottsdale, AZ
  • NPI 1578139424
  NPD (past)

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1487312187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 E ACOMA DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13236 N 26TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325903",
            "telephone_number": "605-929-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERDAL",
        "first_name": "SANDRA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AG11210010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WIPF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyle Ryan Leong, DO
• Alexandria Estelle Leovic, PHYSICIAN ASSISTANT
• Michael Phillip Leovic, MD
• Ken Michael Lepinskas, DDS
• Abigail Rose Lepinski, DO
• Valerie Lerma
• Krista N Lerner, DDS
• Amanda Sarah Lernor, D.P.M.
• Charlotte Leroux, BPHARM, PHD
• David Ralph Lersch, MD

• Gerontology Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.