Audrey Lundin, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201609120NP-PP Issued in OR

Practice address

5100 S Macadam Ave Ste 200
Portland, OR 97239-3827

Phone

(971) 202-5500

Fax

(971) 202-5555

NPI assigned

Nov 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Audrey Rose De Luna Cantor Lundin Other name

Medicare fee-for-service enrollment

Enrolled in OR

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marquis Clinical Services LLCGroup PAC ID 2860827821, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audreyroselundin@hpi.allscriptsdirect.net
• Direct secure messaging: alundin@landmarkhealth-direct.org

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.

• Marquis Clinical Services LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Milwaukie, OR
  • NPI 1710427810

  Gerontology

  Medicare reassignment Care Compare group NPD
• Housecall Providers, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1396274817
  Medicare reassignment NPD
• Housecall Providers Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1619915774
  NPD
• Landmark Health of Oregon LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1205226214
  NPD (past)

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1962945295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9020 SW Washington Square Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972234435",
            "country_code": "US",
            "telephone_number": "503-420-5852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5933 NE Win Sivers Dr Ste 305",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209106",
            "country_code": "US",
            "telephone_number": "503-420-5852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDIN",
        "first_name": "AUDREY",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201609120NP-PP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201609120NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY ROSE",
            "last_name": "LUNDIN",
            "middle_name": "DE LUNA CANTOR",
            "credential": "AGPCNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brianna Leanne Lundgren
• Eli Lundgren
• Gary Duane Lundgren, RPH
• Makenzy Lundgren, BIRTH DOULA
• Megan Lundgren
• Lindsey Lundin, LPC
• Carolyn Marie Lundstrom, LCSW
• Emily Elizabeth Lundstrom, MD
• Dana Lundy, QMHA-R
• Jonathan James Lundy, PHD

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.