NPIMap

Individual provider Active NPI

Candace Nysted, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1164996922
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9280 Issued in OR
Practice address
2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone
(541) 779-6250
Fax
(541) 608-2470
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 9280 OR Primary

Addresses

Primary practice location

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674

Mailing address

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone (541) 779-6250

Other practice location 1

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309
Phone (928) 453-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241029000688 AZ Practitioner - Physician Assistant 0244600690 Reassigns benefits to 2 organizations
I20260326002457 OR Practitioner - Physician Assistant 0244600690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians
Southern Oregon Orthopedics IncGroup PAC ID 1456256528, 64 clinicians

Practice addresses (Care Compare)

2035 Mesquite Ave
Lake Havasu City, AZ 86403-5894
Phone 92845319705894

2500 Canyon Rd
Suite A1
Bullhead City, AZ 86442-8492
Phone (928) 704-4499

2780 E Barnett Rd
Suite 200
Medford, OR 97504-8674
Phone (541) 779-6250

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309
Phone (928) 453-1970

3151 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 458-7583

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9280ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sundance Medical Associates PLLC Single Specialty Past Accepting new patients
Desert Angels Medical Clinic PLC Single Specialty PastSince Sep 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCCDA
  • Direct secure messaging: candace.nysted.1@3291.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 6

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": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1164996922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-608-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-608-2470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Lake Havasu Ave S",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864039309",
            "country_code": "US",
            "telephone_number": "928-453-1970",
            "fax_number": "833-450-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYSTED",
        "first_name": "CANDACE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "9280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.