Individual provider Active NPI

Amy Kelly

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1396614285
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-23580 Issued in AZ
Practice address
5363 N Sabino Canyon Rd Apt 12
Tucson, AZ 85750-7089
Phone
(520) 261-2034
NPI assigned
Oct 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-23580 AZ Primary
Clinical Social Worker 1041C0700X P016996 NC

Addresses

Primary practice location

5363 N Sabino Canyon Rd Apt 12
Tucson, AZ 85750-7089

Mailing address

5363 N Sabino Canyon Rd Apt 12
Tucson, AZ 85750-7089
Phone (520) 261-2034

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260504005931 AZ Practitioner - Clinical Social Worker 1850869389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Escalera Health LLCGroup PAC ID 1951650985, 55 clinicians

Practice addresses (Care Compare)

6303 E Tanque Verde Rd
Suite 210
Tucson, AZ 85715-3859
Phone (520) 896-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-23580AZMDClinical Social Worker
P016996NCMDClinical Social Worker

Organizations & group practices 1

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": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1396614285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 N SABINO CANYON RD APT 12",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507089",
            "telephone_number": "520-261-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 N SABINO CANYON RD APT 12",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507089",
            "telephone_number": "520-261-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-30",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-23580",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.