Individual provider Active NPI

Liliana Nanez, M.D.

  • Vascular Surgery Physician
  • Raleigh, NC
National Provider Identifier
1053636894
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2016-00599 Issued in NC
Practice address
4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone
(919) 784-2300
Fax
(919) 784-2301
NPI assigned
Apr 5, 2010
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2016-00599 NC
Vascular Surgery Physician 2086S0129X 2016-00599 NC Primary

Addresses

Primary practice location

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521

Mailing address

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone (919) 784-2300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lnanez169802@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817000664 NC Practitioner - General SurgeryPractitioner - Vascular Surgery 8729373659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

11200 Governor Manly Way
Suite 303a
Raleigh, NC 27614-7375
Phone (919) 784-2300

300 Health Park Dr
Garner, NC 27529-4685

320 Veterans Pkwy
Suite 100
Clayton, NC 27520-2728
Phone (919) 784-2300

4420 Lake Boone TRL
Raleigh, NC 27607-7505

781 Avent Ferry Rd
Holly Springs, NC 27540-7776

850 S Main St
Holly Springs, NC 27540-8906
Phone (984) 215-4000

910 Berkshire Rd
Smithfield, NC 27577-4751
Phone (919) 784-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal30
Leg revascularization (restoring blood flow)25
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-00599NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

11200 Governor Manly Way
Ste 303A
Raleigh, NC 27614
Phone (919) 570-7590

4414 Lake Boone Trl
Ste 505
Raleigh, NC 27607
Phone (984) 974-0500

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • Direct secure messaging: lnanez169802@direct.unc.nchie.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1053636894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-784-2300",
            "fax_number": "919-784-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-784-2300",
            "fax_number": "919-784-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANEZ",
        "first_name": "LILIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2016-00599",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2016-00599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnanez169802@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4414 Lake Boone Trl Ste 505",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.