Active NPI
Kelvin Coleman, PA-C
- Physician Assistant
- Goodyear, AZ
National Provider Identifier
1578873519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4690
- Practice address
- 13677 W McDowell Rd
Goodyear, AZ 85395-2635 - Phone
- (623) 882-1500
- NPI assigned
- Oct 8, 2010
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4690 | AZ | Primary |
Addresses
Primary practice location
13677 W McDowell Rd
Goodyear, AZ 85395-2635
Mailing address
13677 W McDowell Rd
Goodyear, AZ 85395-2635
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4690 | AZ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians Professional Association LTD | Past | Accepting new patients | |
| Puerto Sonora Internal Medicine | Past | Accepting new patients |
Organizations & group practices 7
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.
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- Psychiatry Physician
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AZ
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- Emergency Medicine Physician
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- Internal Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1578873519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13677 W MCDOWELL RD",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853952635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13677 W MCDOWELL RD",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853952635",
"telephone_number": "623-882-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "KELVIN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-08",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "4690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.