NPIMap

Individual provider Active NPI

Tanya Leal Condiano, PA-C

  • Medical Physician Assistant
  • Davidson, NC
National Provider Identifier
1093461246
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-14179 Issued in NC
Practice address
108 S Main St Ste C
Davidson, NC 28036-8096
Phone
(980) 259-2498
NPI assigned
Feb 25, 2022
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-14179 NC Primary

Addresses

Primary practice location

108 S Main St Ste C
Davidson, NC 28036-8096

Mailing address

108 S Main St Ste C
Davidson, NC 28036-8096
Phone (980) 259-2498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240528000816 NC Practitioner - Physician Assistant 4688051113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kasaji Medical PCGroup PAC ID 2466815600, 4 clinicians

Practice addresses (Care Compare)

5820 E W T Harris Blvd
Suite B
Charlotte, NC 28215-3542
Phone (914) 589-9963

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tpereira2947786@carolinashealthcaresystem.direct-ci.com

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 9

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1093461246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S MAIN ST STE C",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368096",
            "telephone_number": "980-259-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S MAIN ST STE C",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368096",
            "telephone_number": "980-259-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDIANO",
        "first_name": "TANYA",
        "middle_name": "LEAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-14179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.