Individual provider Active NPI

Lindsey Lily Virgadaula, FNP-C

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1821724279
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
306147 Issued in AZ
Practice address
725 W Elliot Rd Ste 115
Gilbert, AZ 85233-5301
Phone
(480) 545-0000
NPI assigned
Jul 28, 2022
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 306147 AZ Primary

Addresses

Primary practice location

725 W Elliot Rd Ste 115
Gilbert, AZ 85233-5301

Mailing address

725 W Elliot Rd Ste 115
Gilbert, AZ 85233-5301
Phone (480) 545-0000

Other practice location 1

1620 President Ave
Fall River, MA 02720-7148
Phone (508) 672-2403

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
I20241001004031 AZ Practitioner - Nurse Practitioner 4688050206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gilbert Physical Medicine LLCGroup PAC ID 2466697982, 5 clinicians

Practice addresses (Care Compare)

725 W Elliot Rd
Suite 115
Gilbert, AZ 85233-5301
Phone (480) 545-0000

Merit-based Incentive Payment System (MIPS)

Final score
85.9 of 100Reported as group
Quality
82.55
Improvement activities
40
Cost
84.99

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gilbert Physical Medicine LLC CurrentSince Sep 1, 2024 Accepting new patients
Revitalize Health and Wellness PLLC Past Accepting new patients

Locations

725 W Elliot Rd
Ste 115
Gilbert, AZ 85233
Phone (480) 500-6251

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": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1821724279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 W ELLIOT RD STE 115",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335301",
            "telephone_number": "480-545-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W ELLIOT RD STE 115",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335301",
            "telephone_number": "480-545-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 President Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027207148",
            "country_code": "US",
            "telephone_number": "508-672-2403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIRGADAULA",
        "first_name": "LINDSEY",
        "middle_name": "LILY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "306147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.