Daisy Hannah Liljenquist, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8371 Issued in AZ

Practice address

2919 S Ellsworth Rd Ste 102
Mesa, AZ 85212-2165

Phone

(480) 404-1776

NPI assigned

Jun 14, 2021

Sex

Female

Sole proprietor

No

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 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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mesa Physical Medicine PLLC 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mesa Physical Medicine PLLC

  • Primary Care Nurse Practitioner
  • Mesa, AZ
  • NPI 1154774305

  AZ

  Medicare reassignment Care Compare group
• Bella Healthcare LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tempe, AZ
  • NPI 1386065183

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1740858976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W BASELINE RD UNIT 230",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025879",
            "telephone_number": "731-334-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122165",
            "telephone_number": "480-404-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILJENQUIST",
        "first_name": "DAISY",
        "middle_name": "HANNAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Light House Group Home LLC
• Light House Group Home LLC
• Light Touch Laser and Dental Implant Center, PLLC
• Lighthouse Support Services LLC
• Lighthouse Support Services LLC
• Loren Edgar Lilly, RRT
• Christine Lillywhite, M.S., MT-BC
• Alice Lim, DDS
• Kellie Marie Lim, PA-C
• Ruth T. Lim, M.D.

• All providers in Mesa, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.