Katy Anne Kirk, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R74417 Issued in AZ

Practice address

20940 N Tatum Blvd Ste 300
Phoenix, AZ 85050-7273

Phone

(480) 607-0060

Fax

(480) 607-5809

NPI assigned

Jun 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katy.kirkmd.p1@direct.desertridgefp.nextgenshare.com

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.

• Mountain View Family Physicians

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1891990867
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1720490352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20940 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507273",
            "telephone_number": "480-607-0060",
            "fax_number": "480-607-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20940 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507273",
            "telephone_number": "480-607-0060",
            "fax_number": "480-607-5809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 N 12th St Ste 605",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062850",
            "country_code": "US",
            "telephone_number": "602-839-2668",
            "fax_number": "602-839-2067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KATY",
        "middle_name": "ANNE",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R74417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282098",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makya Kirchner, LMSW
• Samantha Kirgis, RBT
• Lydia Romanovna Kirillova, MD
• Alison Danielle Kirk, M.D.
• Brant Evan Kirk, M.D.
• Kenneth Kirk
• Lauren Elizabeth Kirk
• Sandra Miriam Kirkby, FNP-BC
• Nikia Kirkendoll, PSYD
• Gary Edward Kirkilas II, D.O.

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.