Individual provider Active NPI

Melissa Joy Kim, PA-C

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1326559568
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6926 Issued in AZ
Practice address
15396 N 83Rd Ave Ste E
Peoria, AZ 85381-5627
Phone
(480) 561-3062
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 6926 AZ Primary

Addresses

Primary practice location

15396 N 83Rd Ave Ste E
Peoria, AZ 85381-5627

Mailing address

6627 W Bent Tree Dr
Phoenix, AZ 85083-7525
Phone (623) 695-4430

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
I20171101003488 AZ Practitioner - Physician Assistant 3274899588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Liver Health LLCGroup PAC ID 3274898010, 20 clinicians

Practice addresses (Care Compare)

2201 W Fairview St
Suite 9
Chandler, AZ 85224-4704
Phone (480) 470-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6926AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Liver Health, LLC CurrentSince Oct 6, 2025 Accepting new patients
4C Medical Group PLC Past Accepting new patients

Locations

600 S Dobson Rd
Ste B10
Chandler, AZ 85224
Phone (480) 745-8577

2201 W Fairview St
Ste 9
Chandler, AZ 85224
Phone (480) 407-4000

1150 N San Francisco St
Flagstaff, AZ 86001
Phone (928) 779-7880

15396 N 83rd Ave
Ste E
Peoria, AZ 85381
Phone (623) 241-9028

15396 N 83rd Ave
Bldg E
Peoria, AZ 85381
Phone (623) 234-3638

1601 N Swan Rd
Tucson, AZ 85712
Phone (520) 485-4000

Organizations & group practices 2

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1326559568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6627 W BENT TREE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850837525",
            "telephone_number": "623-695-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15396 N 83RD AVE STE E",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815627",
            "telephone_number": "480-561-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MELISSA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.