Kandy Lizzeth Medina Perez, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RNP267355 Issued in AZ

Practice address

13755 N Litchfield Rd Ste 105
Surprise, AZ 85379-4288

Phone

(623) 248-7404

Fax

(949) 437-2917

NPI assigned

May 4, 2021

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

Other names 1

• Kandy Lizzeth Medina Perez Other name

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, 2021

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

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.

• Waddell Family Care PLLC

  • Primary Care Clinic/Center
  • Surprise, AZ
  • NPI 1144974395
  Medicare reassignment Authorized official
• 4C Medical Group PLC

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD (past)

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1972186138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7908 N COTTON LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853559751",
            "telephone_number": "623-512-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 N LITCHFIELD RD STE 105",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853794288",
            "telephone_number": "623-248-7404",
            "fax_number": "949-437-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PEREZ",
        "first_name": "KANDY",
        "middle_name": "LIZZETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN211082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP267355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANDY",
            "last_name": "MEDINA PEREZ",
            "middle_name": "LIZZETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Med Mobility LLC
• Jolie Elizabeth Medan, BSN
• Medevent911 LLC
• Medflight911 Air Ambulance Service LLC
• Medical and Surgical Health and Healing Institute, L.L.C.
• Vanessa Medina
• Medirad, LLC
• Michael Reyes Medrano, PHD
• Jay G Mehta, DO
• Kishor D Mehta, MD

• Family Nurse Practitioner in Surprise, AZ
• Providers in Surprise, 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 Aug 21, 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.