Individual provider Active NPI

Kailey Perry, PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1104584101
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2730 S Val Vista Dr
Gilbert, AZ 85295-1675
Phone
(480) 394-0200
NPI assigned
Dec 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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 Primary

Addresses

Primary practice location

2730 S Val Vista Dr
Gilbert, AZ 85295-1675

Mailing address

2730 S Val Vista Dr
Gilbert, AZ 85295-1675
Phone (480) 394-0200

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
I20211227001251 AZ Practitioner - Physician Assistant 0345631495 Reassigns benefits to 1 organization

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
Arizona State Urological Institute LLCGroup PAC ID 7719962000, 17 clinicians

Practice addresses (Care Compare)

21300 N John Wayne Pkwy
Maricopa, AZ 85139-8978
Phone (480) 394-0200

2730 S Val Vista Dr
Suite 177
Gilbert, AZ 85295-1683
Phone (480) 394-0200

910 E Pecos Rd
Chandler, AZ 85225-2461
Phone (480) 394-0200

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
  • Banner Ocotillo Medical Center Hospital, Chandler, AZ, CCN 030147

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8799AZMDPediatric Physical Therapist

Interoperability endpoints

  • Direct secure messaging: kailey.perry@363.securemail.prognocis.com

Organizations & group practices 1

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 4

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1104584101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951675",
            "telephone_number": "480-394-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951675",
            "telephone_number": "480-394-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KAILEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.