Individual provider Active NPI

Christiana Kachala

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1255977260
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3196 S Maryland Pkwy Ste 425
Las Vegas, NV 89109-2318
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3196 S Maryland Pkwy Ste 425
Las Vegas, NV 89109-2318

Mailing address

PO Box 12357
Augusta, GA 30914-2357
Phone (706) 863-9595

Other practice location 1

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (706) 863-9595

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
I20211129001043 AZ Practitioner - Physician Assistant 9436587789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8568AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince May 1, 2022 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince May 1, 2022 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Toca at Banner Health LLC CurrentSince Oct 18, 2021 Accepting new patients

Locations

1125 S Alma School Rd
Ste 210
Chandler, AZ 85286
Phone (480) 256-4900

1920 N Higley Rd
Ste 306
Gilbert, AZ 85234
Phone (480) 543-2606

1920 N Higley Rd
Ste 206
Gilbert, AZ 85234
Phone (480) 543-6700

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

7701 W Aspera Blvd
Ste 102
Glendale, AZ 85308
Phone (623) 248-2100

18700 N 64th Dr
Ste 220
Glendale, AZ 85308

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381
Phone (623) 523-6560

2222 E Highland Ave
Ste 300
Phoenix, AZ 85016
Phone (602) 483-6165

9377 E Bell Rd
Ste 231
Scottsdale, AZ 85260
Phone (602) 313-1549

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

5002 S Mill Ave
Tempe, AZ 85282
Phone (602) 512-8607

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1255977260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12357",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309142357",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 425",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092318",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3186 S Maryland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891092317",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACHALA",
        "first_name": "CHRISTIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.