Tanya Leal Condiano, PA-C
Individual provider Active NPI Medical Physician Assistant · Davidson, NC
NPI 1093461246 · NPPES record last updated Jul 28, 2026
Key facts
- NPI
- 1093461246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 0010-14179 (NC)
- Practice address
- 108 S Main St Ste C
Davidson, NC 28036-8096 - Phone
- (980) 259-2498
- NPI assigned
- Feb 25, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kasaji Medical PC
Practice addresses (Care Compare)
5820 E W T Harris Blvd
Suite B
Charlotte, NC 28215-3542
Phone (914) 589-9963
Hospital & facility affiliations
- Carolinas Medical Center/Behav Health
- Atrium Health Cleveland
- Stanly Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240528000816 | NC | Practitioner - Physician Assistant | 4688051113 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-14179 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimed Hospitalists | Current |
Accepting new patients |
Locations
625 Bethany Rd
Albemarle, NC 28001
Phone (704) 982-0770
557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361
Interoperability endpoints
- tpereira2947786@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-14179 | NC | Yes |
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
Other providers in Davidson, NC
- Erin M Clark
- Kelley Cock
- Coleman and Dastrup PLLC
- Dennis J. Coleman
- Herbert Neal Collins Jr.
- Allison Jane Copeck
- Ryan Austin Corbello
- Laquanda Malika Coulote
- Creative Psychology With Dr. Dug PLLC
- M. Dewitt Crosby
All providers in Davidson, NC · Medical Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.