Kaitlyn Hendrix, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7726 Issued in AZ

Practice address

15256 N 75TH Ave Ste 360
Peoria, AZ 85381-4761

Phone

(623) 486-2424

Fax

(623) 486-4324

NPI assigned

Mar 23, 2021

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 10

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Life Physical Medicine and Pain Center PLLCGroup PAC ID 0941350953, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Active Life Physical Medicine and Pain Center, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Surprise, AZ
  • NPI 1811130016
  Medicare reassignment Care Compare group
• Afc of East Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1972256857
  Medicare reassignment
• Afc of Peoria, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Peoria, AZ
  • NPI 1154668044
  Medicare reassignment
• Afc of Phoenix, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1619392362
  Medicare reassignment
• Afc of Surprise, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Surprise, AZ
  • NPI 1255912721
  Medicare reassignment
• Afc of Tempe PLLC

  • Physical Medicine & Rehabilitation Physician
  • Tempe, AZ
  • NPI 1255879854
  Medicare reassignment
• Afc Physical Medicine of Desert Ridge,PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1669731303
  Medicare reassignment
• Afc Physical Medicine of Gilbert, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Gilbert, AZ
  • NPI 1528345881
  Medicare reassignment
• Afc Physical Medicine of Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1659645679
  Medicare reassignment
• Afc Physical Medicine of San Tan Valley, PLLC

  • Physical Medicine & Rehabilitation Physician
  • San Tan Valley, AZ
  • NPI 1457638603
  Medicare reassignment

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1467038950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-503-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15256 N 75TH AVE STE 360",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814761",
            "telephone_number": "623-486-2424",
            "fax_number": "623-486-4324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 S Lindsay Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-726-2500",
            "fax_number": "480-726-2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 E Baseline Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852047290",
            "country_code": "US",
            "telephone_number": "480-345-1980",
            "fax_number": "480-926-1721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1277 E Missouri Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850142916",
            "country_code": "US",
            "telephone_number": "602-296-4060",
            "fax_number": "602-296-4146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270 E Hunt Hwy Ste A-2",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851434962",
            "country_code": "US",
            "telephone_number": "480-882-2222",
            "fax_number": "480-882-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14239 W Bell Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853742470",
            "country_code": "US",
            "telephone_number": "623-248-4283",
            "fax_number": "623-440-4255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2145 E Warner Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843549",
            "country_code": "US",
            "telephone_number": "480-664-9443",
            "fax_number": "480-664-9378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2919 S Ellsworth Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122165",
            "country_code": "US",
            "telephone_number": "480-564-1185",
            "fax_number": "480-590-4375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20860 N Tatum Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504282",
            "country_code": "US",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7629170001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7047150001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "70349500001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7046960001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "704516001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7939960001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7209350001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "8220410001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7057360001",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adra Helmich
• Stephen R Hempelman, MD
• Mohamad Hemu, MD
• Felicia Megan Hendricks, RD
• Ashley Hendrickson, M.S. SLP
• Sean Hennessy
• Katrina Henry-Boudreaux, PHARMD
• Stephanie Henry
• Cynthia Gaye Herda-Keith, RN
• Steven M Herf, M.D.

• Medical Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.