Lorraine D Fajardo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11074 Issued in AZ

Practice address

3608 E Desert Moon TRL
San Tan Valley, AZ 85143-3366

Phone

(480) 677-4240

NPI assigned

Mar 14, 2018

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

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspen Medical PLLCGroup PAC ID 8224469432, 3 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 and National Provider Directory roles.

• Aspen Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1013542240
  Medicare reassignment Care Compare group NPD
• DFDV Health and Wellness LLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1689367112
  Medicare reassignment NPD

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1669975876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 E DESERT MOON TRL",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851433366",
            "telephone_number": "480-677-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 E DESERT MOON TRL",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851433366",
            "telephone_number": "480-677-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "LORRAINE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Spencer Evans, CNC
• Evergreen Healthcare Treatment LLC
• Lorena Everhart, PT
• Experience Physical Therapy LLC
• Chidozie C Eze, FNP
• Anyssa Falcon, SLPA
• Famond Care Network LLC
• Shannon Paula Farrell, SLP
• Laura Xian Feng
• Olivia Ferguson, ED.S.

• Family Nurse Practitioner in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.