Active NPI
Brant Evan Kirk, M.D.
- Surgery Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 52882
- Practice address
- 4212 N 16TH St
Phoenix, AZ 85016-5319 - Phone
- (602) 263-1200
- NPI assigned
- Apr 8, 2011
- Last updated
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.38 of 100
- 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Ridge Indian Health Service Hospital | Current | Accepting new patients | |
| Siskiyou Hospital, Inc. | Current | Accepting new patients | |
| Jarvis Tzeng DO P a | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| Navajo Health Foundation-Sage Memorial Hospital, Inc. | Current | Accepting new patients | |
| Pine Ridge Indian Health Service Hospital | Current | Accepting new patients | |
| Navajo Health Foundation-Sage Memorial Hospital Inc | Current | Accepting new patients | |
| Pine Ridge Indian Health Service Hospital | Current | 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.
-
dba Whiteriver Indian Hospital
- General Acute Care Hospital
- Whiteriver, AZ
- NPI 1427335140
TX
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1104104488
-
dba Sage Memorial Physicians
- Rural Acute Care Hospital
- Ganado, AZ
- NPI 1477735777
-
dba Pine Ridge IHS Hospital
- General Acute Care Hospital
- Pine Ridge, SD
- NPI 1497786412
TX
-
dba Fairchild Medical Center
- Critical Access Hospital
- Yreka, CA
- NPI 1093892275
-
dba Sage Memorial Hospital
- Critical Access Hospital Clinic/Center
- Ganado, AZ
- NPI 1518957398
-
dba LaCreek District Clinic
- Clinic/Center
- Martin, SD
- NPI 1003208257
-
dba Wanblee Health Center
- Clinic/Center
- Wanblee, SD
- NPI 1962559518
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.