MEDICARE: NIVEDITA NANDURKAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	R82310	AZ

General Provider Information

NPI Number	:	1083558530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIVEDITA NANDURKAR MD

Provider Business Mailing Address
First Line	:	12073 E LUPINE AVE
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85259-3361
Country	:	US
Telephone Number	:	718-902-5564
Fax Number	:

Provider Business Practice Location Address
First Line	:	16605 E PALISADES BLVD STE 150
Second Line	:
City	:	FOUNTAIN HILLS
State	:	AZ
Zip	:	85268-3717
Country	:	US
Telephone Number	:	480-837-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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