Penny Burkert, P.A.-C.
Individual provider Active NPI Medical Physician Assistant · Tempe, AZ
NPI 1477565943 · NPPES record last updated Dec 28, 2010
Key facts
- NPI
- 1477565943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 1492 (AZ)
- Practice address
- 6655 S Rural Rd
Suite 3
Tempe, AZ 85283-3793 - Phone
- (480) 831-0600
- Fax
- (480) 820-3065
- NPI assigned
- Aug 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alia Family Practice Inc
Practice addresses (Care Compare)
6655 S Rural Rd
Tempe, AZ 85283-3793
Phone (480) 831-0600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060321000322 | AZ | Practitioner - Physician Assistant | 0244247971 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1492 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Primary Care | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1492 | AZ | Yes |
Addresses
Primary practice location
6655 S Rural Rd
Suite 3
Tempe, AZ 85283-3793
Mailing address
6655 S Rural Rd
Suite 3
Tempe, AZ 85283-3793
Phone (480) 831-0600
Other providers in Tempe, AZ
- Anthony R Burgan
- Richard A Burgmeier
- Lawrence Paul Burk Sr.
- Stacey Ann Burk
- Victoria Dynda Burke
- Robert Stephen Burkhart
- Joshua Edwinson Burnett
- Dennis J Burns
- Monica Jill Burns
- Nicole Burns
All providers in Tempe, AZ · Medical Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.