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TANYA KIDANDI
NPI 1104294875
Nurse Practitioner - Primary Care in Fort Worth, TX

Active since September 10, 2015PECOS EnrolledAccepts Medicare Assignment
1325 PENNSYLVANIA AVE STE 560, FORT WORTH, TX 76104(817) 250-7240 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tanya Kidandi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TANYA KIDANDI (NPI 1104294875) is an individual primary care provider in Fort Worth, Texas, licensed in Texas (1030527) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Fort Worth, and maintains a secondary practice location in Milwaukee.

NPPES Registry Identity

NPI1104294875
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameTANYA KIDANDI
Location Address1325 PENNSYLVANIA AVE STE 560Fort Worth, TX 76104-2152
Mailing Address2900 W Oklahoma AveMilwaukee, WI 53215-4330
Phone(817) 250-7240
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 10, 2015
Last NPPES UpdateOctober 9, 2024
NPPES CertifiedOctober 9, 2024
✔ NPI 1104294875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in TX · 1030527
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 6586-33 (WI)
1325 PENNSYLVANIA AVE STE 560, Fort Worth, TX 76104
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Secondary Practice Location 1

Location 12900 W Oklahoma AveMilwaukee, WI 53215-4330 · Phone (414) 649-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tanya Kidandi is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759690431
PECOS Enrollment IDI20241024000027
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450135
Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
4 suppliers62 claims38,040 services$1.17 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers21 claims2,940 services$0.35 avg. paid by Medicare
Prednisolone oral, per 5 mg J7510
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier47 claims1,410 services$0.05 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers19 claims2,850 services$0.01 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers63 claims6,660 services$1.02 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
4 suppliers31 claims31 services$19.10 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHANSLER VALENTINE DAVIS PA-C
Physician Assistant (Surgical)
1325 PENNSYLVANIA AVE STE 560
FORT WORTH, TX 76104
Tarrant County (817) 250-7240
SUZANNE MARIE CRABTREE RD
Dietitian, Registered
1325 PENNSYLVANIA AVE STE 560
FORT WORTH, TX 76104
Tarrant County (817) 820-2890
KIMBERLY LATOYA WASHINGTON M.D.
Surgery
1325 PENNSYLVANIA AVE STE 560
FORT WORTH, TX 76104
Tarrant County (817) 250-7240

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tanya Kidandi's NPI number?

The NPI number for Tanya Kidandi is 1104294875. It was assigned to this individual provider in the NPPES registry on September 10, 2015.

Where is Tanya Kidandi located?

Tanya Kidandi practices at 1325 Pennsylvania Ave Ste 560, Fort Worth, TX 76104. The listed phone number is (817) 250-7240.

What is Tanya Kidandi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Tanya Kidandi enrolled in Medicare?

Yes. Tanya Kidandi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tanya Kidandi accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Tanya Kidandi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tanya Kidandi affiliated with any hospitals?

According to CMS data, Tanya Kidandi is affiliated with Texas Health Harris Methodist Hospital Fort Worth.

When was this NPI record last updated?

The NPPES record for Tanya Kidandi was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.