Brent Timothy Kunzler, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19659 Issued in CA

Practice address

207 W Legion Rd
Brawley, CA 92227-7780

Phone

(760) 351-3130

Fax

(760) 351-3137

NPI assigned

Mar 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Municipality of Skagway

  • Federally Qualified Health Center (FQHC)
  • Skagway, AK
  • NPI 1063574200
  Medicare reassignment NPD

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1699947192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 PAINTBRUSH WAY",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908319",
            "telephone_number": "435-272-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3130",
            "fax_number": "760-351-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNZLER",
        "first_name": "BRENT",
        "middle_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devendra S Kapoor, MD
• Kestutis V. Kuraitis, M.D., PH.D., Inc.
• Saima Khan, MD
• Mary Kay Klockmann, NP
• Michael Krutzik, MD
• Kestutis V Kuraitis, MD
• La Suarez a Professional Corporation
• Christopher C Lai, MD
• Kevin Larkin
• Trang Lee

• Physician Assistant in Brawley, CA
• Providers in Brawley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.