Individual provider Active NPI

Jessel Reuen Coomansingh, PA-C

  • Medical Physician Assistant
  • Litchfield Park, AZ
National Provider Identifier
1306192687
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5336 Issued in AZ
Practice address
13730 W Camelback Rd
Litchfield Park, AZ 85340-3075
Phone
(623) 334-7745
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 5336 AZ
Medical Physician Assistant 363AM0700X 5336 AZ Primary

Addresses

Primary practice location

13730 W Camelback Rd
Litchfield Park, AZ 85340-3075

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

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
I20160603001197 AZ Practitioner - Physician Assistant 8224328257 Reassigns benefits to 1 organization

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
The Little Clinic of Arizona LLCGroup PAC ID 4981797982, 43 clinicians

Practice addresses (Care Compare)

13830 W Camelback Rd
Litchfield Park, AZ 85340-3072
Phone (623) 334-7745

2727 W Bell Rd
Phoenix, AZ 85053-3059
Phone (602) 680-2386

Merit-based Incentive Payment System (MIPS)

Final score
84.28 of 100Reported as group
Quality
69.93
Promoting interoperability
100
Improvement activities
40
Cost
77.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5336AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Express Urgent Care, PC PastSince Sep 7, 2011 Accepting new patients
4C Medical Group PLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessel.coomansingh@krogerhealth.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1306192687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13730 W CAMELBACK RD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403075",
            "telephone_number": "623-334-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMANSINGH",
        "first_name": "JESSEL",
        "middle_name": "REUEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5336",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield Park, AZ

Sources for this page

Verify at the official NPI Registry.