Individual provider Active NPI

Kendall L Novoa Takara, MD

  • Hospitalist Physician
  • Phoenix, AZ
National Provider Identifier
1780635227
Registry record updated Apr 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
41652 Issued in AZ
Practice address
1111 E McDowell Rd
Banner Good Samaritan Hospital, Internal Medicine Dept
Phoenix, AZ 85006-2612
Phone
(602) 839-2296
Fax
(602) 839-2084
NPI assigned
May 12, 2006
Last updated
Apr 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 41652 AZ Primary

Addresses

Primary practice location

1111 E McDowell Rd
Banner Good Samaritan Hospital, Internal Medicine Dept
Phoenix, AZ 85006-2612

Mailing address

1111 E McDowell Rd
Banner Good Samaritan Hospital, Internal Medicine Dept
Phoenix, AZ 85006-2612
Phone (602) 839-2296

Other identifiers 1

IdentifierTypeStateIssuer
444164MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090807000047 AZ Practitioner - Internal Medicine 6204869084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

925 E McDowell Rd
Fl 3
Phoenix, AZ 85006
Phone (602) 839-5895

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1780635227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "address_2": "BANNER GOOD SAMARITAN HOSPITAL, INTERNAL MEDICINE DEPT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2296",
            "fax_number": "602-839-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "address_2": "BANNER GOOD SAMARITAN HOSPITAL, INTERNAL MEDICINE DEPT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2296",
            "fax_number": "602-839-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOA TAKARA",
        "first_name": "KENDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "41652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444164",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.