Individual provider Active NPI

Kevin Kon, PAC

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1124056502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3082 Issued in AZ
Practice address
1066 N Power Rd
Ste 101
Mesa, AZ 85205
Phone
(480) 776-1588
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3082 AZ Primary

Addresses

Primary practice location

1066 N Power Rd
Ste 101
Mesa, AZ 85205

Mailing address

27208 N 65TH Dr
Phoenix, AZ 85085
Phone (623) 825-5022

Other identifiers 1

IdentifierTypeStateIssuer
043383MedicaidAZ

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
I20060302000407 AZ Practitioner - Physician Assistant 0345256186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
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)

10240 N 43Rd Ave
Suite 3
Glendale, AZ 85302-2044
Phone (623) 742-2060

1394 W 16TH St
Yuma, AZ 85364-4430
Phone (928) 539-0055

14800 W Mountain View Blvd
Suite 190
Surprise, AZ 85374-2700
Phone (623) 385-7299

17688 W Elliot Rd
Goodyear, AZ 85338-9009
Phone (623) 889-6823

18589 N 59TH Ave
Suite 101
Glendale, AZ 85308-1258
Phone (602) 547-2600

20470 N Lake Pleasant Rd
Suite 102
Peoria, AZ 85382-9708
Phone (623) 825-4600

2122 N Scottsdale Rd
Scottsdale, AZ 85257-2123
Phone (480) 889-3570

3850 W Greenway Rd
Suite 150
Phoenix, AZ 85053-3731
Phone (480) 508-5777

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

9745 W Bell Rd
Suite 105
Sun City, AZ 85351-1371
Phone (623) 742-2999

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apache Junction Urgent Care LLC Past Accepting new patients
Sun City Urgent Care LLC Past Accepting new patients
Thomas Road Urgent Care LLC Past Accepting new patients
Nextcare Arizona LLC Past Accepting new patients
Greenway Urgent Care LLC Past Accepting new patients
Desert Ridge Urgent Care LLC Past Accepting new patients
Pinnacle Medicine Inc. Past Accepting new patients
Southwest Phoenix Urgent Care LLC Past Accepting new patients
Chandler Urgent Care LLC Past Accepting new patients
Avondale Urgent Care LLC Past Accepting new patients
Shea Urgent Care LLC Past Accepting new patients
Glendale Urgent Care LLC Past Accepting new patients
Dana Landing Urgent Care LLC Past Accepting new patients
Casa Grande Urgent Care LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kevin.konpa.p1@direct.nextcare.nextgenshare.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124056502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27208 N 65TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85085",
            "telephone_number": "623-825-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N POWER RD",
            "address_2": "STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-776-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KON",
        "first_name": "KEVIN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "3082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043383",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.