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WADDELL FAMILY CARE
NPI 1144974395
Clinic/Center - Primary Care in Surprise, AZ

Active since February 07, 2022CLIA 03D2293248 · Waiver
13755 N LITCHFIELD RD STE 105, SURPRISE, AZ 85379(623) 512-8308(949) 437-2917 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 21, 2024, Feb 7, 2022 (2 updates tracked since 2022).

About Waddell Family Care NPPES

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

WADDELL FAMILY CARE (NPI 1144974395) is a healthcare organization registered as a primary care in Surprise, Arizona and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through November 5, 2027 and lists Kandy Lizzeth Medina Perez, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1144974395
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameWADDELL FAMILY CARE PLLC
Location Address13755 N LITCHFIELD RD STE 105Surprise, AZ 85379-4288
Mailing Address7908 N Cotton LnWaddell, AZ 85355-9751 · (623) 512-8308
Phone(623) 512-8308
Fax(949) 437-2917
Organization SubpartNo
Authorized OfficialKandy Lizzeth Medina PerezOwner/provider · (623) 512-8308
Enumeration DateFebruary 7, 2022
Last NPPES UpdateAugust 21, 20242 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
✔ NPI 1144974395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
13755 N LITCHFIELD RD STE 105, Surprise, AZ 85379
Open in Google Maps ↗

Other Names 1

Doing Business AsWaddell Family Care

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Waddell Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Waddell Family Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kandy Medina Perez, FNP-C
Nurse Practitioner
NPI 1972186138
13755 N LITCHFIELD RD STE 105
Surprise, AZ 85379
(623) 248-7404
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2293248

Waddell Family Care · Surprise, AZ
Active · expires Nov 5, 2027
CLIA Number03D2293248
Laboratory TypePhysician Office
Certificate Effective DateNovember 6, 2025
Certificate Expiration DateNovember 5, 2027
Laboratory DirectorKandy Medina Perez
Laboratory Phone(623) 248-7404
Laboratory LocationWaddell Family Care13755 N Litchfield Rd Ste 105, Surprise, AZ 85379
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Waddell Family Care PLLC's NPI number?

The NPI number for Waddell Family Care PLLC is 1144974395. It was assigned to this organization in the NPPES registry on February 7, 2022. The provider is doing business as Waddell Family Care.

Where is Waddell Family Care PLLC located?

Waddell Family Care PLLC is located at 13755 N Litchfield Rd Ste 105, Surprise, AZ 85379. The listed phone number is (623) 512-8308.

What is Waddell Family Care PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Waddell Family Care PLLC enrolled in Medicare?

Yes. Waddell Family Care PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Waddell Family Care PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Waddell Family Care PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Waddell Family Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2293248) is associated with this NPI, valid through November 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Waddell Family Care PLLC was last updated on August 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.