Individual provider Active NPI

Bernadette Marie Andalkar, ACNP-BC

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1851681498
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP4026 Issued in AZ
Practice address
2045 S Vineyard Ste 142
Mesa, AZ 85210
Phone
(480) 330-6010
NPI assigned
Apr 17, 2011
Last updated
Jul 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP4026 AZ Primary
Acute Care Nurse Practitioner 363LA2100X AP4026 AZ

Addresses

Primary practice location

2045 S Vineyard Ste 142
Mesa, AZ 85210

Mailing address

6535 N 61St St
Paradise Valley, AZ 85253-4235

Other practice location 1

10187 E Peak Cir
Scottsdale, AZ 85262-8330
Phone (520) 490-8368

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
I20190721000004 AZ Practitioner - Nurse Practitioner 0345588729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2045 S Vineyard
Suite 144
Mesa, AZ 85210-6891
Phone (520) 490-8368

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4026AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Neurosurgery, LLC Current Accepting new patients
Arizona Spine and Joint Hospital LLC Current Accepting new patients
Arizona Valley Diagnostics LLC Current Accepting new patients
Agave Surgical Services LLC Acute Care CurrentSince Dec 22, 2018 Accepting new patients

Locations

2045 S Vineyard
Ste 142
Mesa, AZ 85210
Phone (480) 330-6010

2045 S Vineyard
Ste 144
Mesa, AZ 85210
Phone (480) 330-6010

Interoperability endpoints

  • Direct secure messaging: bernadetteandalkar@asjh.medalliesdirect.net

Organizations & group practices 4

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": "1302998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1851681498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 N 61ST ST",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852534235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD STE 142",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85210",
            "telephone_number": "480-330-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10187 E Peak Cir",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852628330",
            "country_code": "US",
            "telephone_number": "520-490-8368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDALKAR",
        "first_name": "BERNADETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-17",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP4026",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.