Kamran Javadi, PA-C, MPH

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9681 Issued in AZ

Practice address

1 Clinic Rd
Grand Canyon, AZ 86023-0290

Phone

(928) 638-2551

NPI assigned

Dec 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• El Rio Santa Cruz Neighborhood Health Center, Inc

  dba El Rio Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1487602736
  Medicare reassignment
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1821228826
  NPD
• North Country Healthcare, Inc.

  dba Flagstaff Pediatric Care

  • Pediatrics Physician
  • Flagstaff, AZ
  • NPI 1669911764
  NPD (past)

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1326635905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1231",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857021231",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLINIC RD",
            "city": "GRAND CANYON",
            "state": "AZ",
            "postal_code": "860230290",
            "telephone_number": "928-638-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVADI",
        "first_name": "KAMRAN",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9681",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "91664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• El Rio Santa Cruz Neighborhood Health Center Inc
• El Rio Santa Cruz Neighborhood Health Center Inc (Elk Ridge Grand Canyon)
• Elk Ridge Grand Canyon Pharmacy
• Erinn E Gallagher, DO
• Mary Gdula, FNP
• Megan June Mahoney, PT
• Thomas Martin, PT
• Dawn Mielke, MD
• National Park Service (Grand Canyon National Park)
• North Country Healthcare Inc.

• Physician Assistant in Grand Canyon, AZ
• Providers in Grand Canyon, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.