Victoria Lifuka Ndambasha, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP10685 Issued in AZ

Practice address

177 W Cottonwood LN Ste 6
Casa Grande, AZ 85122-2552

Phone

(520) 233-5905

Fax

(520) 233-5910

NPI assigned

Jun 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Sun Life Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1508276940

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1982196234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 W COTTONWOOD LN STE 6",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222552",
            "telephone_number": "520-233-5905",
            "fax_number": "520-233-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 W COTTONWOOD LN STE 6",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222552",
            "telephone_number": "520-233-5905",
            "fax_number": "520-233-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDAMBASHA",
        "first_name": "VICTORIA",
        "middle_name": "LIFUKA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natural Hospice, LLC
• Gabriel Navoa
• Deepak Nayyar, M.D.
• Nazcare, Inc
• Nazcare, Inc. - Casa Grande Wellness Center
• Carla Mae Neill
• John Anthony Neves, DMD
• New Horizon Youth Homes, Inc
• Aaron Timothy Newton, PA-C
• Nextcare Arizona LLC

• Family Nurse Practitioner in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.