Individual provider Active NPI

Laramie Kuykendall, PA

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1063138170
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10566 Issued in AZ
Practice address
1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone
(480) 412-3000
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X KS
Physician Assistant 363A00000X 10566 AZ Primary
Emergency Medicine Physician 207P00000X 4865 OK
Physician Assistant 363A00000X 15-02718 KS

Addresses

Primary practice location

1400 S Dobson Rd
Mesa, AZ 85202-4707

Mailing address

674 Belmar Blvd
Norman, OK 73071-8006
Phone (405) 740-8459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241011000339 AZ Practitioner - Physician Assistant 7810359742 Reassigns benefits to 1 organization
I20260616001538 OK Practitioner - Physician Assistant 7810359742

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Mid-America PCGroup PAC ID 2062638661, 86 clinicians

Practice addresses (Care Compare)

2825 Parklawn Dr
Midwest City, OK 73110-4201
Phone (405) 610-4411

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4865OKMDEmergency Medicine Physician
10566AZMDPhysician Assistant
15-02718KSMDPhysician Assistant
10556AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Kansas LLC Emergency Medicine CurrentSince Aug 7, 2023 Accepting new patients
Cep America- Arizona, PC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Cep America - Kansas LLC Emergency Medicine CurrentSince Aug 7, 2023 Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1063138170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 BELMAR BLVD",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730718006",
            "telephone_number": "405-740-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024707",
            "telephone_number": "480-412-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "LARAMIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10566",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4865",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.