Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carmencita Medalle

Individual provider Registered Nurse · NPI 1346133196

Carmencita Medalle is a Nurse Practitioner in Goodyear, Arizona. Qualified in 2025, 1 year ago. Practices with Banner Primary Care Physicians Arizona LLC, a 237-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

1800 N Civic Sq Ste 200
Goodyear, AZ 85395-2391
Phone: (623) 465-6506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 325706 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence RN187226 (AZ)

Record details

NPI number1346133196
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 30, 2025
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Banner Primary Care Physicians Arizona Llc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Goodyear