Kyla Ballesteros, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4886 Issued in AZ

Practice address

1250 S Clearview Ave
Suite 100
Mesa, AZ 85209-3378

Phone

(480) 988-9108

Fax

(480) 813-4460

NPI assigned

May 28, 2009

Last updated

Dec 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyla.ballesteros.1@6657.direct.athenahealth.com

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.

• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Payson, AZ
  • NPI 1194369074
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1962855031
  NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  NPD (past)
• Ucxtra Umbrella, LLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1518952365
  NPD (past)

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1548495997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191534",
            "telephone_number": "520-881-0636",
            "fax_number": "520-881-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE",
            "address_2": "SUITE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093378",
            "telephone_number": "480-988-9108",
            "fax_number": "480-813-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTEROS",
        "first_name": "KYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668590",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynnette Fae Balentine, NMD
• Aisha Bales, CRNA
• Daniel Ballard, PA
• Karen Kay Ballard, NP
• Kaylen Manning Ballenger, FNP-C
• Shelley Poyner Baltodano, AU.D.
• Jeffrey Richard Banas, DC
• Vinay Bandla, M.D
• Sunitha Bandlamuri, MD
• Joshua Bangle

• Surgical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.