Kierstin Lealiiee

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10838 Issued in AZ

Practice address

6410 S Kings Ranch Rd Ste 1
Gold Canyon, AZ 85118-7352

Phone

(480) 761-2500

Fax

(480) 288-2879

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deseret Medical Associates PLCGroup PAC ID 5698026409, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.22 of 100Reported as group

Quality

90.13

Improvement activities

40

Cost

73.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klealiiee@stgec.direct.eyemdemr.com

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.

• Deseret Medical Associates PLC

  • Family Medicine Physician
  • Gold Canyon, AZ
  • NPI 1962989244
  Medicare reassignment Care Compare group
• St George Eye Center

  • Ophthalmology Physician
  • St George, UT
  • NPI 1073996344
  Medicare reassignment NPD
• Deseret Family Practice, LTD.

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1215960638

  Family Medicine

  NPD (past)
• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  NPD (past)
• Tuttle Dermatology PC

  • Dermatology Physician
  • St George, UT
  • NPI 1598261869
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1124644182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N 2940 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907096",
            "telephone_number": "602-489-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD STE 1",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-761-2500",
            "fax_number": "480-288-2879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3760 E Leah Ln",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852340023",
            "country_code": "US",
            "telephone_number": "602-489-1313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "617 E Riverside Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847908720",
            "country_code": "US",
            "telephone_number": "435-628-4507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEALIIEE",
        "first_name": "KIERSTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2437",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "11959125-1206",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "10838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Marie Lancaster, NP
• Charles William Lang, RPH
• Nicole Alexandria Laramie
• Christi Larson
• Christie Lathrop
• Gabriela Lynn Lien
• Linda Carol Newell MD
• Sidnee Paige Lofgreen
• Corianne Kathleen Lopez
• James Aaron Loui

• Family Medicine Physician in Gold Canyon, AZ
• Providers in Gold Canyon, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.