Individual provider Active NPI

Ian Jonathan Kallmeyer, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1083694947
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
33591 Issued in AZ
Practice address
1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633
Phone
(602) 744-4765
Fax
(602) 744-4799
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 33591 AZ Primary

Addresses

Primary practice location

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633

Mailing address

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633
Phone (602) 744-4765

Other identifiers 2

IdentifierTypeStateIssuer
938173MedicaidAZ
P00268732OtherMEDICARE RAILROAD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060104000621 AZ Practitioner - Anesthesiology 9234152372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

3535 N Scottsdale Rd
Scottsdale, AZ 85251-5625
Phone (480) 882-4365

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-4000

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (480) 323-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33591AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Dec 1, 2005 Accepting new patients
Metrowest Anesthesiology, Inc. Anesthesiology PastSince Nov 14, 1996 Accepting new patients

Locations

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

2901 N Central Ave
Ste 500
Phoenix, AZ 85012
Phone (602) 744-4765

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

Organizations & group practices 2

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 3

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1083694947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLMEYER",
        "first_name": "IAN",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "33591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "938173",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00268732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.