Individual provider Active NPI

Kristin Beitz, PA-C

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1215038237
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5655 Issued in AZ
Practice address
7425 E Shea Blvd Ste 102
Scottsdale, AZ 85260-6411
Phone
(480) 660-8823
Fax
(480) 660-8801
NPI assigned
Sep 25, 2006
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA866 NV
Physician Assistant 363A00000X 5655 AZ Primary

Addresses

Primary practice location

7425 E Shea Blvd Ste 102
Scottsdale, AZ 85260-6411

Mailing address

7425 E Shea Blvd Ste 102
Scottsdale, AZ 85260-6411
Phone (480) 660-8823

Other identifiers 1

IdentifierTypeStateIssuer
100507748MedicaidNV

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
I20140702001278 AZ Practitioner - Physician Assistant 3173707486 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5655AZMDPhysician Assistant
PA866NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Health Services PLLC PastSince May 24, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1215038237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 E SHEA BLVD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606411",
            "telephone_number": "480-660-8823",
            "fax_number": "480-660-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 E SHEA BLVD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606411",
            "telephone_number": "480-660-8823",
            "fax_number": "480-660-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEITZ",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA866",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507748",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.