AGAVE SURGICAL SERVICES LLC
NPI 1477026862
Nurse Practitioner - Acute Care in Mesa, AZ
About Agave Surgical Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AGAVE SURGICAL SERVICES LLC (NPI 1477026862) is a healthcare organization registered as an acute care in Mesa, Arizona and active in the NPI registry since January 2019. The organization lists Bernadette Andalkar, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Agave Surgical Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Agave Surgical Services LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Agave Surgical Services LLC's NPI number?
The NPI number for Agave Surgical Services LLC is 1477026862. It was assigned to this organization in the NPPES registry on January 8, 2019.
Where is Agave Surgical Services LLC located?
Agave Surgical Services LLC is located at 2045 S Vineyard Ste 142, Mesa, AZ 85210. The listed phone number is (480) 330-6010.
What is Agave Surgical Services LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Agave Surgical Services LLC enrolled in Medicare?
Yes. Agave Surgical Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Agave Surgical Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Agave Surgical Services LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Agave Surgical Services LLC was last updated on January 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# Agave Surgical Services Llc · NPI 1477026862
Acute Care organization in Mesa, Arizona. Organization record, active in the CMS NPPES registry since January 8, 2019.
## Identity
- **NPI:** 1477026862 (Entity type: Organization)
- **Enumerated:** January 8, 2019
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **Organization subpart:** No
- **Authorized official:** Bernadette Andalkar, OWNER
## Practice location
- **Address:** 2045 S VINEYARD STE 142, Mesa, AZ 85210-6891
- **Phone:** (480) 330-6010
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 8, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1477026862) · Data from the CMS NPPES public registry.