Agave Surgical Services LLC
NPI 1477026862ActiveOrganization· Nurse Practitioner, Acute Care· Mesa, AZ
Nurse Practitioner, Acute Care in Mesa, Arizona, registered in NPPES in January 2019. The authorized official on file is Bernadette Andalkar, ACNP-BC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1477026862 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 8, 2019 |
| Last updated in NPPES | Jan 8, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Acute Care Primary | 363LA2100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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