Individual provider Active NPI

Kathleen Elias, NP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1235761115
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
236617 Issued in AZ
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(602) 943-2381
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 236617 AZ
Gerontology Nurse Practitioner 363LG0600X 236617 AZ
Acute Care Nurse Practitioner 363LA2100X 236617 AZ Primary

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

9225 N 3Rd St Ste 300
Phoenix, AZ 85020-2466
Phone (602) 445-0751

Other practice location 1

9225 N 3rd St Ste 300
Phoenix, AZ 85020-2466
Phone (602) 445-0751

Other identifiers 2

IdentifierTypeStateIssuer
003365MedicaidAZ
Z238145OtherAZPTAN

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
I20200303002945 AZ Practitioner - Nurse Practitioner 4981031937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Hospitalists PLCGroup PAC ID 6204822869, 84 clinicians

Practice addresses (Care Compare)

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
236617AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Hospitalists, PLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

9225 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 870-1821

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255
Phone (480) 324-7000

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

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, 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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1235761115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 N 3RD ST STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202466",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "602-943-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9225 N 3rd St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850202466",
            "country_code": "US",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "236617",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "236617",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "236617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003365",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z238145",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.