Kevin William Canedy, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1293 6TH St
Coachella, CA 92236-1707

Phone

(760) 391-5151

NPI assigned

Sep 12, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (1 of 2)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Coachella Valley Care Medical Associates Inc

  • Family Medicine Physician
  • Indio, CA
  • NPI 1811319890

  CA

  Medicare reassignment
• Indio Emergency Medical Group Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Palm Desert, CA
  • NPI 1376766808

  CA

  Medicare reassignment
• Indio Emergency Med Group Inc

  • Emergency Medicine Physician
  • Indio, CA
  • NPI 1326064759
  NPD

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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

{
    "created_epoch": "1631404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1609545656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 6TH ST",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361707",
            "telephone_number": "760-391-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 6TH ST",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361707",
            "telephone_number": "760-391-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANEDY",
        "first_name": "KEVIN",
        "middle_name": "WILLIAM",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-12",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Punsit Buakaew, PHARMD
• C&S Pharmacy
• C&S Pharmacy
• Brianna Ashley Calderon, PHARMD
• Cynthia Calderon
• Anitza Maribel Carlos-Mora
• Carissa Carlson
• Laura Castillo-Dominguez, LVN
• Veronica Isabel Castillo
• Allison Castro

• All providers in Coachella, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.