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ANDRE LUIZ BEZERRA FNP
NPI 1093528655
Nurse Practitioner in Grants Pass, OR

Active since January 28, 2025PECOS EnrolledAccepts Medicare Assignment
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526(541) 472-4777(541) 471-1439 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 3, 2026, Mar 24, 2026, Feb 21, 2025 and 1 more (4 updates tracked since 2025).

About Andre Luiz Bezerra Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDRE LUIZ BEZERRA FNP (NPI 1093528655) is an individual nurse practitioner in Grants Pass, Oregon, licensed in Oregon (10053410) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS, is affiliated with Asante Three Rivers Medical Center, and maintains a secondary practice location in Cave Junction.

NPPES Registry Identity

NPI1093528655
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameANDRE LUIZ BEZERRACredential: FNP
Location Address1701 NW HAWTHORNE AVEGrants Pass, OR 97526-1051
Mailing Address1701 Nw Hawthorne AveGrants Pass, OR 97526-1051 · (541) 472-4777 · Fax (541) 471-1439
Phone(541) 472-4777
Fax(541) 471-1439
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 28, 2025
Last NPPES UpdateApril 3, 20264 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
✔ NPI 1093528655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OR · 10053410
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1701 NW HAWTHORNE AVE, Grants Pass, OR 97526
Open in Google Maps ↗

Secondary Practice Location 1

Location 125647 Redwood HwyCave Junction, OR 97523-9332 · Phone (541) 592-4111 · Fax (541) 592-3916

Other Identifiers 1

Medicaid500867922OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andre Luiz Bezerra Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749700359
PECOS Enrollment IDI20260331004447
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Andre Bezerra reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Siskiyou Community Health Center, Inc
Same address
Federally Qualified Health Center (FQHC)
1701 NW HAWTHORNE AVE
Grants Pass, OR 97526
  • Reassigned Medicare billing, Oregon enrollment
  • 27 clinicians in this Medicare group
NPI 1427046903 (541) 472-4777
Mayo Clinic Jacksonville
2,454 mi
Health Service
4500 SAN PABLO RD S
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 1,828 clinicians in this Medicare group
NPI 1174143986 (904) 953-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Asante Three Rivers Medical Center

Acute Care Hospitals · Grants Pass, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380002
Location500 SW Ramsey AvenueGrants Pass, OR 97527 · Josephine County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97526 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONA KAAHU PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 471-3455
DR. KEATON JAMES FLETCHER DO
Family Medicine
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 472-4777
MS. AMY TRIPP
Dental Hygienist
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 479-6393
DR. DONALD RAY DRAPER DMD
Dentist (Dental Public Health)
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 479-6393
LAURA ANDERSON DNP APRN-NP
Nurse Practitioner
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 472-4777
MRS. KIMBERLY L WALLER PA-C
Physician Assistant
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 471-3455
SISKIYOU COMMUNITY HEALTH CENTER INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 472-4777
ELIZABETH ANNE MABRY CSWI
Social Worker (Clinical)
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526
Josephine County (541) 472-4777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andre Bezerra's NPI number?

The NPI number for Andre Bezerra is 1093528655. It was assigned to this individual provider in the NPPES registry on January 28, 2025.

Where is Andre Bezerra located?

Andre Bezerra practices at 1701 NW Hawthorne Ave, Grants Pass, OR 97526. The listed phone number is (541) 472-4777.

What is Andre Bezerra's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Andre Bezerra enrolled in Medicare?

Yes. Andre Bezerra is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Andre Bezerra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andre Bezerra reassigns Medicare benefits to 2 organizations: Siskiyou Community Health Center, Inc (Grants Pass, OR) and Mayo Clinic Jacksonville (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andre Bezerra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andre Bezerra accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Andre Bezerra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Andre Bezerra affiliated with any hospitals?

According to CMS data, Andre Bezerra is affiliated with Asante Three Rivers Medical Center.

When was this NPI record last updated?

The NPPES record for Andre Bezerra was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.