Individual provider Active NPI

Samantha Lynn Kelley

  • Physician Assistant
  • Litchfield Park, AZ
National Provider Identifier
1699509679
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10538 Issued in AZ
Practice address
14044 W Camelback Rd Ste 118
Litchfield Park, AZ 85340-9481
Phone
(623) 547-2600
Fax
(623) 547-1899
NPI assigned
Aug 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 10538 AZ Primary

Addresses

Primary practice location

14044 W Camelback Rd Ste 118
Litchfield Park, AZ 85340-9481

Mailing address

14044 W Camelback Rd Ste 118
Litchfield Park, AZ 85340-9481
Phone (623) 547-2600

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
I20240918002814 AZ Practitioner - Physician Assistant 7911448972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Digestive Health PCGroup PAC ID 6507940731, 134 clinicians

Practice addresses (Care Compare)

10290 N 92ND St
Suite 207
Scottsdale, AZ 85258-4500
Phone (623) 547-2600

13760 N 93Rd Ave
Suite 101
Peoria, AZ 85381-4203
Phone (623) 547-2600

14044 W Camelback Rd
Suite 118
Litchfield Park, AZ 85340-9481
Phone (623) 547-2600

19636 N 27TH Ave
Suite 202
Phoenix, AZ 85027-4018
Phone (623) 547-2600

20201 N Scottsdale Healthcare Dr
Suite 280
Scottsdale, AZ 85255-4140
Phone (623) 547-2600

2222 E Highland Ave
Suite 225
Phoenix, AZ 85016-4877
Phone (623) 547-2600

5823 W Eugie Ave
Suite a
Glendale, AZ 85304-1277
Phone (602) 843-1265

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Verde Hematology Oncology LTD. CurrentSince Sep 3, 2024 Accepting new patients
Arizona Digestive Health, PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3624 W Anthem Way
Ste C122
Anthem, AZ 85086
Phone 62343457483

5823 W Eugie Ave
Ste A
Glendale, AZ 85304
Phone (602) 439-1717

6320 W Union Hills Dr
Ste 2600B
Glendale, AZ 85308
Phone (602) 942-5600

14044 W Camelback Rd
Ste 118
Litchfield Pk, AZ 85340
Phone (623) 584-4882

26900 N Lake Pleasant Pkwy
Ste 201
Peoria, AZ 85383

13760 N 93rd Ave
Ste 101
Peoria, AZ 85381
Phone (623) 876-3800

2222 E Highland Ave
Ste 225
Phoenix, AZ 85016
Phone (602) 298-7777

9250 W Thomas Rd
Ste 150
Phoenix, AZ 85037
Phone (623) 478-8091

20201 N Scottsdale Healthcare Dr
Ste 280
Scottsdale, AZ 85255
Phone (480) 505-3484

20201 N Scottsdale Rd
Ste 280
Scottsdale, AZ 85255
Phone (480) 505-3484

9425 W Bell Rd
Ste 200
Sun City, AZ 85351

Organizations & group practices 2

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": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1699509679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 118",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409481",
            "telephone_number": "623-547-2600",
            "fax_number": "623-547-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 118",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409481",
            "telephone_number": "623-547-2600",
            "fax_number": "623-547-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield Park, AZ

Sources for this page

Verify at the official NPI Registry.