AUDREY LUNDIN (AGPCNP) – Gerontology Nurse Practitioner, NPI 1962945295
Gerontology Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for AUDREY LUNDIN (AGPCNP)
PO BOX 3158
PORTLAND, OR 972083158
Phone: (503) 215-6494
Type: Mailing
4400 NE HALSEY ST
PORTLAND, OR 972131545
Phone: (503) 215-0750
Type: Location
5100 S MACADAM AVE STE 200
PORTLAND, OR 972393827
Phone: (971) 202-5500
Fax: (971) 202-5555
Type: Location
5933 NE Win Sivers Dr Ste 305
Portland, OR 972209106
Phone: (503) 420-5852
Type: Location
9020 SW Washington Square Rd Ste 100
Tigard, OR 972234435
Phone: (503) 420-5852
Type: Location
Southwest Washington Square Road, Washington Square Too, North Tigard, Tigard, Metro, Washington County, Oregon, 97223, United States
TIGARD, OR 972234435
Phone: (503) 420-5852
Type: Mailing
Northeast Win Sivers Drive, Parkrose, Portland, Metro, Multnomah County, Oregon, 97220, United States
PORTLAND, OR 972209106
Phone: (503) 420-5852
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170104001196 | I | Nurse Practitioner | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 57 | 23 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 15 | 11 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 14 | 14 | $0 |
| 99497 | Advance care planning, first 30 minutes | 12 | 11 | $0 |
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OR | |
| - | OR | |
| Internal Medicine | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| Physician Assistant | CA | |
| Nurse Practitioner | OR |
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