Kendal Packer

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10238 E Hampton Ave Ste 404
Mesa, AZ 85209-3319

Phone

(480) 771-7546

NPI assigned

Sep 21, 2016

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HW Dermatology PLLCGroup PAC ID 4880951201, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• HW Dermatology PLLC

  dba Sunrise Dermatology

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1750800033
  Medicare reassignment Care Compare group
• Equality Medical Group LLC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1770148322
  NPD (past)
• Hamblin Dermatology PLLC

  • Dermatology Physician
  • Show Low, AZ
  • NPI 1568851350
  NPD (past)
• Equality Health at Home Inc

  • Internal Medicine Physician
  • Frisco, TX
  • NPI 1730936329
  NPD (past)

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1023566817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155124",
            "telephone_number": "602-889-9401",
            "fax_number": "602-889-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE STE 404",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093319",
            "telephone_number": "480-771-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "KENDAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z194890",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184512",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael A Pachtman, M.D.
• Pacific Behavioral Center Inc
• Pacific Developmental Abilities, LLC
• Jesse Lauren Pack, FNP-C
• Blair J Packard II, PT
• Nina Padilla-Hurst
• Brionna Padilla
• Nayely Padilla, MSW
• Stacy Padilla, PHARMD
• Alexander Padron Alonso

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.