Cory M Kovac, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3363 Issued in AZ

Practice address

19350 E Silver Creek LN
Queen Creek, AZ 85142-9064

Phone

(480) 718-5400

Fax

(877) 666-4624

NPI assigned

Jun 3, 2006

Last updated

Feb 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272
  Medicare reassignment NPD
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199

  ID

  Medicare reassignment NPD
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment NPD
• Intermountain Emergency Physicians

  • Emergency Medicine Physician
  • Idaho Falls, ID
  • NPI 1124005467
  Medicare reassignment
• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment
• Caribou Medical Center, Inc

  dba Lakeview Medical Clinic

  • Rural Health Clinic/Center
  • Soda Springs, ID
  • NPI 1548930878
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Gooding, ID
  • NPI 1275703241
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Imaging Center Twin Falls

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Casa Grande Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Casa Grande, AZ
  • NPI 1871589051
  NPD (past)
• Ucxtra Umbrella, LLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1518952365
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1093753709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 S BURK ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962815",
            "telephone_number": "480-588-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19350 E SILVER CREEK LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429064",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAC",
        "first_name": "CORY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3363",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023682",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Knife, PHARM.D.
• Alfred Knight
• Laura Kobar, MS, MC, LPC
• Stephanie Deborah Kotsur, NP
• Kellie M Kotwicki, MS, BCBA, LBA
• Madison Christine Kowalski, PA-C
• Mindy Kraus, M.ED, BCBA, LBA
• Drew Ann Krempin, RN
• Karen Kruse, M.A., CCCSLP
• Diane R Kuhlmann, LPN

• Physician Assistant in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.