Individual provider Active NPI

Andrea Nicole Stevens, FNP

  • Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1992341150
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
63151 Issued in ID
Practice address
1115 12TH Ave Rd
Nampa, ID 83686-5738
Phone
(208) 498-1080
Fax
(208) 498-1080
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 63151 ID Primary

Addresses

Primary practice location

1115 12TH Ave Rd
Nampa, ID 83686-5738

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20200122002352 ID Practitioner - Nurse Practitioner 0042645970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

1820 Caldwell Blvd
Nampa, ID 83651-1505
Phone (208) 466-6567

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
77.29
Promoting interoperability
97
Improvement activities
40
Cost
74.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Family Medicine Current Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince Jan 6, 2020 Accepting new patients

Locations

8971 W Overland Rd
Boise, ID 83709
Phone (208) 378-4288

7350 W Victory Rd
Boise, ID 83709
Phone (208) 809-2888

300 W Myrtle St
Ste 100
Boise, ID 83702
Phone (208) 472-9082

4815 Cleveland Blvd
Caldwell, ID 83605
Phone (208) 455-3545

435 S Eagle Rd
Ste 100
Eagle, ID 83616
Phone (208) 609-9130

1895 McGrath Rd
Eagle, ID 83616
Phone (208) 939-8200

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

5601 W Chinden Blvd
Garden City, ID 83714
Phone (208) 809-2865

1623 S Wells Ave
Meridian, ID 83642
Phone (208) 489-1450

260 S Ten Mile Rd
Meridian, ID 83642
Phone (208) 809-2872

1115 12th Ave Rd
Nampa, ID 83686
Phone (208) 498-1080

1820 Caldwell Blvd
Nampa, ID 83651
Phone (208) 466-6567

Interoperability endpoints

  • Direct secure messaging: andrea.stevens@phmg.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1992341150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865738",
            "telephone_number": "208-498-1080",
            "fax_number": "208-498-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "63151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.