Kelly M Kollman, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3449 Issued in AZ

Practice address

8761 E Bell Rd
Suite 105
Scottsdale, AZ 85260-1315

Phone

(480) 219-6662

Fax

(480) 219-6596

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

No

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.

• Southeast Valley Gastroenterology Consultants, P.C.

  • Gastroenterology Physician
  • Chandler, AZ
  • NPI 1104861905

  AZ

  Medicare reassignment Care Compare group
• Saint Paul Place Specialists, Inc.

  • Physical Therapist
  • Baltimore, MD
  • NPI 1346292422
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Valley Gastroenterology Consultants, P.C. 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.kollman@directaddress.net

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2011.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1710053533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 29901",
            "address_2": "DEPT. 994",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850380901",
            "telephone_number": "480-219-6662",
            "fax_number": "480-219-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8761 E BELL RD",
            "address_2": "SUITE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601315",
            "telephone_number": "480-219-6662",
            "fax_number": "480-219-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMAN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00624725",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160229",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jansy Kolandra, MD
• Courtney Elizabeth Kolberg, AUD
• Kenneth William Koldys, M.D.
• Martin Kollasch, D.C.
• Christine Koller, RN
• Serena Kolofer
• Michael Kolotinsky, ND
• Andrew Jonathan Kolp, PHARMD
• Yulia K Koltzova-Rang, M.D.
• Darci M Komac, O.T.

• All providers in Scottsdale, AZ
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.