Individual provider Active NPI

Nestazia Khamis, PA-C

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1104661735
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10750 W Whitehorn Way
Peoria, AZ 85383-9799
Phone
(623) 256-4780
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

10750 W Whitehorn Way
Peoria, AZ 85383-9799

Mailing address

10750 W Whitehorn Way
Peoria, AZ 85383-9799
Phone (623) 256-4780

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
I20241017001350 AZ Practitioner - Physician Assistant 8123550969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

914 N Scottsdale Rd
Suite 104
Tempe, AZ 85288-2116
Phone (480) 924-8382

9494 W Northern Ave
Suite 101
Glendale, AZ 85305-1119
Phone (623) 872-2226

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: nestazia.khamispac.p1@direct.nextcare.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1104661735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 W WHITEHORN WAY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853839799",
            "telephone_number": "623-256-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W WHITEHORN WAY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853839799",
            "telephone_number": "623-256-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "NESTAZIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.