Individual provider Active NPI

Clinton Phillip Kalan, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1245570936
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4029 Issued in CO
Practice address
11600 W 2ND PL
Lakewood, CO 80228-1527
Phone
(303) 202-1280
NPI assigned
Feb 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 PA2013-0004 NM
Physician Assistant 363A00000X 4029 CO Primary

Addresses

Primary practice location

11600 W 2ND PL
Lakewood, CO 80228-1527

Mailing address

PO Box 5788
Denver, CO 80217-5788
Phone (303) 202-1280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130823001022 NM Practitioner - Physician Assistant 5496998460 Reassigns benefits to 1 organization
I20231011001807 WA Practitioner - Physician Assistant 5496998460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Tacoma, WA 98405-1702

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4029COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Multicare Health System CurrentSince Sep 6, 2023 Accepting new patients
Multicare Health System CurrentSince Sep 6, 2023 Accepting new patients
Unm Medical Group, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Apex Emergency Group, Inc Past Accepting new patients
Steadman Clinic Professional LLC Past Accepting new patients

Locations

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 9

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": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1245570936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5788",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175788",
            "telephone_number": "303-202-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "303-202-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAN",
        "first_name": "CLINTON",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-18",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2013-0004",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.