Lianet Lantigua Ponce de Leon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN305992 Issued in AZ

Practice address

10645 N 43Rd Ave
Phoenix, AZ 85029-3944

Phone

(623) 233-2006

Fax

(602) 314-6115

NPI assigned

May 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HIBCAA
• FHIR API: https://fhir4.healow.com/fhir/r4/IJFGDD/Endpoint/IJFGDD

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.

• Az Wellness Clinica Familiar LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1255163382
  Medicare reassignment NPD
• Town Center Family Practice Inc

  • Primary Care Clinic/Center
  • Orange City, FL
  • NPI 1467148411
  NPD
• Florida Health Care Plan, Inc

  dba FHCP ASC - Orange City

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD (past)

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1265122584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 N 43RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293944",
            "telephone_number": "623-233-2006",
            "fax_number": "602-314-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 N 43RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293944",
            "telephone_number": "623-233-2006",
            "fax_number": "602-314-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTIGUA PONCE DE LEON",
        "first_name": "LIANET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F05230008",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "APRN305992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia M Lankton, LPC, LISAC
• Stephen Ryan Lankton, MSW
• Annette Yvonne Lanman, COTA
• Gwen Lanoue
• Lantana Therapy Services, PLLC
• Laura Lantsberger, NNP
• Marina Lantsman-Waugh, PHD
• Lauren Elizabeth Lanz, FNP
• Louis A Lanza, M.D.
• Tara Marie Lanzendorf, MD

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.