Individual provider Active NPI

Loriel Handlen, PA-C

  • Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1295458149
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2105 N Citrus Rd
Goodyear, AZ 85395-9204
Phone
(623) 853-0304
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2105 N Citrus Rd
Goodyear, AZ 85395-9204

Mailing address

2105 N Citrus Rd
Goodyear, AZ 85395-9204
Phone (623) 853-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230413001901 CA Practitioner - Physician Assistant 8628443249 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Vascular and Endovascular Surgery Center Inc CurrentSince May 24, 2024 Accepting new patients

Locations

11190 Warner Ave
Ste 408
Fountain Vly, CA 92708
Phone (714) 430-1414

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1295458149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 N CITRUS RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959204",
            "telephone_number": "623-853-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 N CITRUS RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959204",
            "telephone_number": "623-853-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDLEN",
        "first_name": "LORIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.