Individual provider Active NPI

Stephanie Qualman

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1982396909
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05230766 Issued in AZ
Practice address
4201 N 68TH St
Scottsdale, AZ 85251-2307
Phone
(520) 609-1096
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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 F05230766 AZ Primary

Addresses

Primary practice location

4201 N 68TH St
Scottsdale, AZ 85251-2307

Mailing address

4201 N 68TH St
Scottsdale, AZ 85251-2307
Phone (520) 609-1096

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
I20240919001124 AZ Practitioner - Nurse Practitioner 8123569068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeline Hospitalist Associates LLCGroup PAC ID 3577961606, 17 clinicians

Practice addresses (Care Compare)

255 W Brown Rd
Mesa, AZ 85201-3404
Phone (480) 833-3988

Hospital & facility affiliations

  • Osborn Health and Rehabilitation Nursing home, Scottsdale, AZ, CCN 035076

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F05230766AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Hospitalist Associates LLC CurrentSince Aug 1, 2024 Accepting new patients
Renewcare of Scottsdale, Inc. Past Accepting new patients

Locations

255 W Brown Rd
Mesa, AZ 85201
Phone (480) 833-3988

4022 E Presidio St
Mesa, AZ 85215
Phone (480) 296-7642

3293 N Drinkwater Blvd
Scottsdale, AZ 85251
Phone (480) 947-7443

Organizations & group practices 3

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.

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": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1982396909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 N 68TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512307",
            "telephone_number": "520-609-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 N 68TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512307",
            "telephone_number": "520-609-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALMAN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "F05230766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.