Active NPI
Kamaile Elizabeth Peck
- Physician Assistant
- Colton, CA
National Provider Identifier
1710864038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 67871
- Practice address
- 400 N Pepper Ave
Colton, CA 92324-1819 - Phone
- (909) 580-1000
- NPI assigned
- Aug 19, 2025
- Sex
- Female
- 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 | 67871 | CA | Primary |
Addresses
Primary practice location
400 N Pepper Ave
Colton, CA 92324-1819
Mailing address
4 Scarborough Way
Rancho Mirage, CA 92270-1624
Phone (720) 431-8912
Other names 1
- Kamaile Elizabeth Conant
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-6150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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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- San Francisco, CA
- NPI 1023063542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1710864038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SCARBOROUGH WAY",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922701624",
"telephone_number": "720-431-8912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241819",
"telephone_number": "909-580-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "KAMAILE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-19",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "67871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAMAILE",
"last_name": "CONANT",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.