Individual provider Active NPI

Kaylyn Lunneborg, NP

  • Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1679469084
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
327449 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone
(480) 301-8000
NPI assigned
Jun 13, 2025
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 327449 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Mailing address

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

Other practice location 1

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klunneborg419986@ehrdirect.mayoclinicmsg.org

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
I20251013002042 AZ Practitioner - Nurse Practitioner 4486141603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327449AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Sep 29, 2025 Accepting new patients
Mayo Clinic Arizona CurrentSince Sep 29, 2025 Accepting new patients

Locations

13400 E Shea Blvd
Scottsdale, AZ 85259

Interoperability endpoints

  • Direct secure messaging: klunneborg419986@ehrdirect.mayoclinicmsg.org

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.

Hospital & facility affiliations 1

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": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1679469084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073106",
            "telephone_number": "312-942-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606073106",
            "country_code": "US",
            "telephone_number": "312-942-5904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNNEBORG",
        "first_name": "KAYLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "327449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klunneborg419986@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.