Individual provider Active NPI

Maegan Lorell Kitzmann

  • Physician Assistant
  • Glendale, AZ
National Provider Identifier
1720347966
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6506 Issued in AZ
Practice address
6622 N 91St Ave Ste 230
Glendale, AZ 85305-2570
Phone
(602) 325-2024
Fax
(720) 925-5897
NPI assigned
May 9, 2012
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 6506 AZ Primary

Addresses

Primary practice location

6622 N 91St Ave Ste 230
Glendale, AZ 85305-2570

Mailing address

5445 DTC Pkwy Ste 1130
Greenwood Village, CO 80111-3038
Phone (720) 749-5599

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
I20161027000741 AZ Practitioner - Physician Assistant 4880972751 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Pain SpecialistsGroup PAC ID 7911255013, 53 clinicians

Practice addresses (Care Compare)

6622 N 91St Ave
Suite 230
Glendale, AZ 85305-2570
Phone (602) 325-2024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6506AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Pain Specialists, PLLC CurrentSince Feb 21, 2022 Accepting new patients
Arizona Pain Specialists, PLLC CurrentSince Feb 21, 2022 Accepting new patients
Mountain View Pain Center Past Accepting new patients

Locations

9787 N 91st St
Ste 101
Scottsdale, AZ 85258
Phone (480) 845-0334

Interoperability endpoints

  • Direct secure messaging: maegan.kitzmann@3675.securemail.prognocis.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1720347966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 N 91ST AVE STE 230",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853052570",
            "telephone_number": "602-325-2024",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMANN",
        "first_name": "MAEGAN",
        "middle_name": "LORELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.