Karlee Kaufman, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

12966819-1206 Issued in UT

Practice address

4403 Harrison Blvd Ste 3680
Ogden, UT 84403-3289

Phone

(801) 387-4750

NPI assigned

Oct 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ, UT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mullen Orthopedic Clinic PLCGroup PAC ID 1850685660, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arizona Orthopedic and Surgical Specialty Hospital Hospital, Phoenix, AZ, CCN 030112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCAIBA/Endpoint/CCAIBA

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.

• Mullen Orthopedic Clinic PLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Mesa, AZ
  • NPI 1568811644

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment
• Ihc Health Services Inc

  dba Park City Sports Medicine

  • Sports Medicine (Internal Medicine) Physician
  • Park City, UT
  • NPI 1619666906

  Multi-Specialty

  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844

  Multi-Specialty

  NPD
• Gilbert PT, LLC

  dba Pain Associates of Gilbert

  • Adult Health Nurse Practitioner
  • Gilbert, AZ
  • NPI 1639472244

  Multi-Specialty

  NPD (past)
• Medwell LLC

  • Pain Medicine Physician
  • Gilbert, AZ
  • NPI 1356756936
  NPD (past)

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

• Orthopedic and Surgical Specialty Company, LLC

  dba Arizona Specialty Hospital

  • Special Hospital
  • Phoenix, AZ
  • NPI 1124163530
  Care Compare affiliation

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1750858080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3680",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033289",
            "telephone_number": "801-387-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3680",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033289",
            "telephone_number": "801-387-4750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10213 N 92nd St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852584561",
            "country_code": "US",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "KARLEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7187",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "12966819-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS",
            "identifier": "7187",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH DOPL",
            "identifier": "12966819-1206",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH DOPL CONTROLLED SUBSTANCE LICENSE",
            "identifier": "12966819-8906",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayne N Kashiwaeda, LCSW
• Abhishek Krishna Kashyap, M.D.
• Tyler Kast, PHARMD
• Timothy John Katsma, PA-C
• Melanie Irene Katz, DMD
• Sujata Devi Kaushal, M.D.
• Jessica Kawecki
• Kayla Jessop Nutrition Company
• Ashley Keck
• Kristi Lee Keding, LCMHC

• Surgical Physician Assistant in Ogden, UT
• Providers in Ogden, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.