Individual provider Active NPI

Kaitlin Anne Kraemer, PA-C

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1548507445
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AZ5266 Issued in AZ
Practice address
9977 N 90TH St Ste 180
Scottsdale, AZ 85258-4426
Phone
(480) 614-5800
Fax
(480) 614-6322
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AZ5266 AZ Primary

Addresses

Primary practice location

9977 N 90TH St Ste 180
Scottsdale, AZ 85258-4426

Mailing address

9977 N 90TH St Ste 180
Scottsdale, AZ 85258-4426
Phone (480) 614-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130315000432 AZ Practitioner - Physician Assistant 3577708767 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5266AZMDGeneral Practice Dentistry
AZ5266AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Group of Arizona Inc CurrentSince Dec 23, 2012 Accepting new patients
Comprehensive Interventional Care Centers, PLLC CurrentSince Sep 16, 2019 Accepting new patients

Locations

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

7620 W Lower Buckeye Rd
Ste 102
Phoenix, AZ 85043
Phone (623) 776-2225

3330 N 2nd St
Ste 502
Phoenix, AZ 85012
Phone (214) 634-0403

4530 E Ray Rd
Ste 190
Phoenix, AZ 85044
Phone (480) 785-0305

3340 W Southern Ave
Ste 131
Phoenix, AZ 85041
Phone (480) 834-8804

16100 N 71st St
Ste 100
Scottsdale, AZ 85254
Phone (480) 656-0016

1492 S Mill Ave
Ste 114
Tempe, AZ 85281
Phone (480) 557-5710

6301 S McClintock Dr
Ste 115
Tempe, AZ 85283
Phone (480) 775-8460

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1548507445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST STE 180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584426",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST STE 180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584426",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAEMER",
        "first_name": "KAITLIN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "AZ5266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.