Kiley Groebner

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4512 N 40TH St
Phoenix, AZ 85018-3604

Phone

(602) 954-7546

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Center for Dermatology, PLLC

  dba Arizona Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1194792416
  Medicare reassignment Care Compare group
• Camelback Dermatology & Skin Surgery, Inc

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1225175441

  Single Specialty

  NPD
• Center for Dermatology, PLLC

  • Medical Physician Assistant
  • Scottsdale, AZ
  • NPI 1174062673

  Single Specialty

  NPD (past)
• English Dermatology PC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1245659432

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1184346116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N 82ND ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852079737",
            "telephone_number": "480-313-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 N 40TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183604",
            "telephone_number": "602-954-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROEBNER",
        "first_name": "KILEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garret Rex Grizzle, D.O.
• Lindsay Jean Grizzle, MD
• Amanda Grjegian, RBT
• Dejana GRK, OD
• Edward Groce
• Giamarie Groenenboom
• Darcie M. Groeper, D.O.
• Winter Groeschl, LPC
• Nicholas B Groesser, DPM
• Ethan Reed Groff, DPT

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.