Krista Deann Pellicore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

48328 Issued in AZ

Practice address

506 E Western Ave Ste 104
Avondale, AZ 85323-2422

Phone

(602) 230-7373

Fax

(602) 230-3086

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthyu Family Medicine LLCGroup PAC ID 6204224918, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24378/brand/3/csg/1/fhir/r4
• Direct secure messaging: krista.pellicore.1@24378.direct.athenahealth.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.

• Healthyu Family Medicine, LLC

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1669149787

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609300854
  Medicare reassignment NPD
• Denova Collaborative Health, LLC

  dba Denova Collaborative Health

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1124549043

  Family Medicine

  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1740079060
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1710283593
  NPD (past)
• Healthyu Glendale Olive

  • Non-Pharmacy Dispensing Site
  • Glendale, AZ
  • NPI 1497451074
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1235174731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E WESTERN AVE STE 104",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853232422",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-3086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 N Litchfield Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853381277",
            "country_code": "US",
            "telephone_number": "602-243-7277",
            "fax_number": "602-323-8048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLICORE",
        "first_name": "KRISTA",
        "middle_name": "DEANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01057388A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "48328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000305690",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200447730",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "857797",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpellicore@denova.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Denova Collaborative Health, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 N Central Ave Ste 550",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850122635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Peace
• David R Pearce
• Isidra Pedrego
• Armando Peelman, EDD, MC
• Steven M Peery, PT, MPT
• Michelle Peral
• Brea Elizabeth Perala, OTD, OTR/L
• Rosa G Perez, MT
• Gabriela Perlas
• Sam Perone

• Family Medicine Physician in Avondale, AZ
• Providers in Avondale, 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 Apr 22, 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.