Kelly Patterson, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

77 W Forest Ave Ste 301
Flagstaff, AZ 86001-1483

Phone

(928) 773-2280

NPI assigned

Aug 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgeons of Northern Arizona P L L CGroup PAC ID 8224922182, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpatterson@directaddress.net

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.

• Plastic Surgeons of Northern Arizona, PLLC

  • Specialist
  • Flagstaff, AZ
  • NPI 1871531418

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment
• Northern Arizona Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Plastic Surgeons of Northern Arizona, PLLC

  • Plastic Surgery Physician
  • Flagstaff, AZ
  • NPI 1154511814

  Single Specialty

  NPD
• Northern Arizona Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
  • NPI 1871596114
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Flagstaff Medical Center

  • Air Ambulance
  • Flagstaff, AZ
  • NPI 1427234111

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Land Ambulance
  • Flagstaff, AZ
  • NPI 1518143205

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875
  Care Compare affiliation
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  Care Compare affiliation

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1447775887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 CYPRESS WAY",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016885",
            "telephone_number": "435-512-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 301",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "928-773-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KELLY",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14079288",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace Berlynn Patel, FNP-BC
• Ian Mark Patience, MD
• Patrick Padrnos O.D. P.C.
• Steven R Patrick, PH.D.
• Susan K Patrick, PSY.D.
• Penni L Patterson, LCSW
• Cody D. Patton, DO
• Paul D Whitney DDS PC
• Leah Marie Coffman Paul, CRNA
• Ronald Evan Paul, LCSW

• Physician Assistant in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.