Individual provider Active NPI

Kati L McLeod, P.A.

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1518230499
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085005565 Issued in IL
Practice address
15022 N 20TH PL
Phoenix, AZ 85022-4049
Phone
(928) 853-7227
NPI assigned
Feb 22, 2012
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5060 AZ
Physician Assistant 363A00000X 3353 CO
Surgical Physician Assistant 363AS0400X 085005565 IL Primary

Addresses

Primary practice location

15022 N 20TH PL
Phoenix, AZ 85022-4049

Mailing address

2650 Warrenville Rd
Suite 280
Downers Grove, IL 60515-1748
Phone (630) 324-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20180130000269 CO Practitioner - Physician Assistant 5496065401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1818 N Ogden St
Suite 400
Denver, CO 80218-1280
Phone (303) 318-2460

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3353COMDMental Health Counselor
5060AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2017 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2017 Accepting new patients
Cardiac Surgery Associates SC Past Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients

Locations

1818 N Ogden St
Ste 400
Denver, CO 80218
Phone (303) 318-2440

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1518230499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD",
            "address_2": "SUITE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151748",
            "telephone_number": "630-324-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15022 N 20TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224049",
            "telephone_number": "928-853-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "KATI",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5060",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3353",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085005565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.