Individual provider Active NPI

Raquiel Andersen, DNP, FNP-C, PMHNP-C

  • Family Nurse Practitioner
  • Ewa Beach, HI
National Provider Identifier
1942811997
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
227558 Issued in AZ
Practice address
5922B Gannet Ave
Ewa Beach, HI 96706-3212
Phone
(808) 746-9247
NPI assigned
Aug 13, 2020
Last updated
May 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-3248 HI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 227558 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-3248 HI
Family Nurse Practitioner 363LF0000X 227558 AZ Primary

Addresses

Primary practice location

5922B Gannet Ave
Ewa Beach, HI 96706-3212

Mailing address

5922B Gannet Ave
Ewa Beach, HI 96706-3212
Phone (808) 746-9247

Other practice location 1

545 Kaaahi St
Honolulu, HI 96817-4652
Phone (808) 746-9247

Other practice location 2

126 S Coronado Dr Ste B
Sierra Vista, AZ 85635-6300
Phone (808) 738-7671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, HI, NV, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20201104002184 AZ Practitioner - Nurse Practitioner 7012327927 Reassigns benefits to 2 organizations
I20230718002224 HI Practitioner - Nurse Practitioner 7012327927 Reassigns benefits to 1 organization
I20241028002210 NV Practitioner - Nurse Practitioner 7012327927 Reassigns benefits to 1 organization
I20260526002169 CA Practitioner - Nurse Practitioner 7012327927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Care LLCGroup PAC ID 1355709973, 2 clinicians

Practice addresses (Care Compare)

5922 B Gannet Ave
Ewa Beach, HI 96706-3212
Phone (808) 738-7671

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227558AZMDFamily Nurse Practitioner
APRN-3248HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adobe PH Ca Medical Group, P.C. Family Medicine CurrentSince May 11, 2026 Accepting new patients
Adobe Provider Group CurrentSince Jul 7, 2023 Accepting new patients
Adobe PH PC Family Medicine CurrentSince Oct 22, 2024 Accepting new patients
Adobe Care and Wellness LLC Past Accepting new patients

Locations

7500 N Dreamy Draw Dr
Ste 100
Phoenix, AZ 85020
Phone (520) 233-7111

7500 N Dreamy Draw Dr
Ste 100B
Phoenix, AZ 85020
Phone (520) 233-7111

135 S State College Blvd
#228
Brea, CA 92821

7251 W Lake Mead Blvd
Ste 300
Las Vegas, NV 89128
Phone (702) 562-4096

Organizations & group practices 5

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 3

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1942811997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5922B GANNET AVE",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063212",
            "telephone_number": "808-746-9247",
            "fax_number": "689-212-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5922B GANNET AVE",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063212",
            "telephone_number": "808-746-9247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Kaaahi St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968174652",
            "country_code": "US",
            "telephone_number": "808-746-9247",
            "fax_number": "689-212-0762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "126 S Coronado Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856356300",
            "country_code": "US",
            "telephone_number": "808-738-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "RAQUIEL",
        "credential": "DNP, FNP-C, PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-3248",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "227558",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN-3248",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "227558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.