Individual provider Active NPI

Kelsey N.S. Pangelinan, DMSC, PA-C

  • Physician Assistant
  • Casa Grande, AZ
National Provider Identifier
1023881331
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11174 Issued in AZ
Practice address
560 N Camino Mercado Ste 7
Casa Grande, AZ 85122-5759
Phone
(480) 900-7256
Fax
(844) 722-0049
NPI assigned
Oct 30, 2023
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11174 AZ Primary

Addresses

Primary practice location

560 N Camino Mercado Ste 7
Casa Grande, AZ 85122-5759

Mailing address

560 N Camino Mercado Ste 7
Casa Grande, AZ 85122-5759
Phone (480) 900-7256

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250819002630 AZ Practitioner - Physician Assistant 7012416787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

1620 E Wilcox Dr
Sierra Vista, AZ 85635-2778
Phone (520) 459-0362

3151 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 458-7583

560 N Camino Mercado
Suite 7
Casa Grande, AZ 85122-5759
Phone (520) 836-5538

8914 N 91St Ave
Suite 100
Peoria, AZ 85345-8390
Phone (623) 877-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
George Fox University PastSince Nov 1, 2023 Accepting new patients
Sundance Medical Associates PLLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1023881331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 N CAMINO MERCADO STE 7",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225759",
            "telephone_number": "480-900-7256",
            "fax_number": "844-722-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N CAMINO MERCADO STE 7",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225759",
            "telephone_number": "480-900-7256",
            "fax_number": "844-722-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGELINAN",
        "first_name": "KELSEY",
        "middle_name": "N.S.",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.