Kaelyn Tkacik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8695 Issued in AZ

Practice address

44870 W Hathaway Ave Ste 6
Maricopa, AZ 85139-9600

Phone

(480) 214-9000

Fax

(480) 214-9999

NPI assigned

Mar 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Enticare PCGroup PAC ID 2264532779, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Enticare PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Chandler, AZ
  • NPI 1710014410
  Medicare reassignment Care Compare group
• Arizona Center for Hematology and Oncology PLC

  • Hematology & Oncology Physician
  • Scottsdale, AZ
  • NPI 1841243722
  Medicare reassignment
• Honorhealth Ambulatory

  • Hematology & Oncology Physician
  • Scottsdale, AZ
  • NPI 1407050917
  Medicare reassignment
• Arizona Center for Hematology and Oncology, PLC

  • Surgery Physician
  • Peoria, AZ
  • NPI 1083007165
  NPD
• Arizona Center for Hematology and Oncology, PLC

  • Urology Physician
  • Surprise, AZ
  • NPI 1174812382
  NPD
• Honorhealth Ambulatory

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1891518130
  NPD
• Scottsdale Healthcare Corp

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1932520533
  NPD
• Sjhmc Physician Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  NPD (past)

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1659966166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44870 W HATHAWAY AVE STE 6",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851399600",
            "telephone_number": "480-214-9000",
            "fax_number": "480-214-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44870 W HATHAWAY AVE STE 6",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851399600",
            "telephone_number": "480-214-9000",
            "fax_number": "480-214-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACIK",
        "first_name": "KAELYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8695",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thy Grace Care LLC
• Barbara Elaine Tilben, DO
• Desiree Tilbury
• Mushina Tillman
• Nshea Tillman, MS
• Together and Free LLC
• April Marie Tomczyk, RN
• Alyssa Tonking, LPC
• Amanda Toppel, NP
• Justine L Torre, RN

• Physician Assistant in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.
• 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.

Verify at the official NPI Registry.