Individual provider Active NPI

Brant Evan Kirk, M.D.

  • Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1477843605
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
52882 Issued in AZ
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 263-1200
NPI assigned
Apr 8, 2011
Last updated
Aug 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 52882 AZ Primary

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0001
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161004002562 TX Practitioner - General Surgery 0749578912 Reassigns benefits to 2 organizations
I20191204001727 CA Practitioner - General Surgery 0749578912 Reassigns benefits to 1 organization
I20210412001770 AZ Practitioner - General Surgery 0749578912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.82
Promoting interoperability
91
Improvement activities
40
Cost
84.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Siskiyou Hospital, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Jarvis Tzeng DO P a CurrentSince Aug 16, 2022 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jul 23, 2018 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jul 23, 2018 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jun 20, 2023 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Jan 10, 2024 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jun 20, 2023 Accepting new patients

Locations

350 E La Canada Blvd
Avondale, AZ 85323
Phone (540) 818-5752

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

475 Bruce St
Ste 900
Yreka, CA 96097

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1477843605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100001",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "BRANT",
        "middle_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "52882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.