Individual provider Active NPI

Kat Deng

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1245979558
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2919 S Ellsworth Rd Ste 135
Mesa, AZ 85212-2168
Phone
(480) 967-6888
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9198 AZ
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2919 S Ellsworth Rd Ste 135
Mesa, AZ 85212-2168

Mailing address

2919 S Ellsworth Rd Ste 135
Mesa, AZ 85212-2168
Phone (480) 967-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250918000355 NY Practitioner - Physician Assistant 2769986272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

130 E 77TH St
New York, NY 10075-1851

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9198AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
George Wang,MD,LLC PastSince Jun 1, 2022 Accepting new patients
George Wang,MD,LLC PastSince Jun 1, 2022 Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: katdeng@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1245979558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD STE 135",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122168",
            "telephone_number": "480-967-6888",
            "fax_number": "480-967-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD STE 135",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122168",
            "telephone_number": "480-967-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENG",
        "first_name": "KAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "9198",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.