Individual provider Active NPI

Caitlin Cassady Chrystal Hall, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1336698695
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6485 Issued in AZ
Practice address
2222 E Highland Ave Ste 300
Phoenix, AZ 85016-4879
Phone
(602) 277-6211
Fax
(602) 277-1074
NPI assigned
Sep 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 6485 AZ Primary

Addresses

Primary practice location

2222 E Highland Ave Ste 300
Phoenix, AZ 85016-4879

Mailing address

3126 N Civic Center PLZ
Scottsdale, AZ 85251-6912
Phone (480) 874-2040

Other practice location 1

3126 N Civic Center Plz
Scottsdale, AZ 85251-6912
Phone (480) 874-2040

Other names 1

  • Caitlin Cassady Chrystal Former name

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
I20161024001582 AZ Practitioner - Physician Assistant 1456639616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2849
Phone (602) 839-3927

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

7400 N Dobson Rd
Suite 201
Scottsdale, AZ 85256-2736
Phone (408) 733-7400

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6485AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Nov 4, 2019 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Nov 4, 2019 Accepting new patients

Locations

4200 E Camelback Rd
Ste 104
Phoenix, AZ 85018
Phone (602) 229-2110

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

7400 N Dobson Rd
Ste 201
Scottsdale, AZ 85256
Phone (480) 733-7400

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.

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": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1336698695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 N CIVIC CENTER PLZ",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516912",
            "telephone_number": "480-874-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164879",
            "telephone_number": "602-277-6211",
            "fax_number": "602-277-1074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3126 N Civic Center Plz",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516912",
            "country_code": "US",
            "telephone_number": "480-874-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "CAITLIN",
        "middle_name": "CASSADY CHRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "CHRYSTAL",
            "middle_name": "CASSADY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.