Individual provider Active NPI

Kathleen Callahan, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1033766902
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8808 Issued in AZ
Practice address
2836 E Indian School Rd Ste A8
Phoenix, AZ 85016-6864
Phone
(602) 840-0056
NPI assigned
Aug 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 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 8808 AZ Primary

Addresses

Primary practice location

2836 E Indian School Rd Ste A8
Phoenix, AZ 85016-6864

Mailing address

PO Box 6610
Chandler, AZ 85246-6610
Phone (602) 840-0056

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
I20220208002571 AZ Practitioner - Physician Assistant 7618360959 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Pointe Psychiatry LLCGroup PAC ID 4284006081, 4 clinicians
Arcadia Medical Group LLCGroup PAC ID 1850642364, 10 clinicians

Practice addresses (Care Compare)

1845 E Broadway Rd
Suite 113
Tempe, AZ 85282-1634
Phone (480) 378-6323

2836 E Indian School Rd
Suite A8
Phoenix, AZ 85016-6864
Phone (480) 926-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8808AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indian School Medical Group, LLC Physician Assistant Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1033766902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6610",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466610",
            "telephone_number": "602-840-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 E INDIAN SCHOOL RD STE A8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166864",
            "telephone_number": "602-840-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-24",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.