Individual provider Active NPI

Kenneth I Levy, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1174712806
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19651 Issued in AZ
Practice address
6838 23Rd Ave
Phoenix, AZ 85015
Phone
(602) 864-8800
Fax
(602) 864-1448
NPI assigned
Oct 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19651 AZ Primary

Addresses

Primary practice location

6838 23Rd Ave
Phoenix, AZ 85015

Mailing address

6838 23Rd Ave
Phoenix, AZ 85015
Phone (602) 864-8800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000131 AZ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1052221603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Tufts University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geriatric Specialties of Arizona PCGroup PAC ID 9931189628, 6 clinicians

Practice addresses (Care Compare)

3666 N Miller Rd
Suite 113
Scottsdale, AZ 85251-4534
Phone (480) 219-9934

6838 N 23Rd Ave
Phoenix, AZ 85015-1056
Phone (602) 864-8800

Hospital & facility affiliations

  • Haven Home Health Care Home health agency, Scottsdale, AZ, CCN 037492
  • Assisted Home Health Home health agency, Phoenix, AZ, CCN 037220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19651AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Specialties of Arizona PC Internal Medicine CurrentSince Apr 1, 2004 Accepting new patients

Locations

6838 N 23rd Ave
Phoenix, AZ 85015
Phone (602) 864-7096

3666 N Miller Rd
Ste 113
Scottsdale, AZ 85251
Phone (480) 219-9934

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 2

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1174712806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6838 23RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85015",
            "telephone_number": "602-864-8800",
            "fax_number": "602-864-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6838 23RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85015",
            "telephone_number": "602-864-8800",
            "fax_number": "602-864-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "KENNETH",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "19651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.