Individual provider Active NPI

Kiana Espinosa, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1790281046
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63498 Issued in AZ
Practice address
1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850
Phone
(602) 839-4567
NPI assigned
Apr 4, 2018
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 63498 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850

Mailing address

1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850
Phone (602) 839-4567

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
I20210817004127 AZ Practitioner - Family Practice 1355693896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Primary Care Physicians LLCGroup PAC ID 2365746450, 45 clinicians

Practice addresses (Care Compare)

1300 N 12TH St
Suite 605
Phoenix, AZ 85006-2850
Phone (602) 839-4567

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Community Center Inc CurrentSince Aug 1, 2021 Accepting new patients
Banner -- University Primary Care Physicians LLC CurrentSince Jul 1, 2022 Accepting new patients
Wesley Community Center Inc Current Accepting new patients
Wesley Community Center, Inc CurrentSince Aug 1, 2021 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

1300 N 12th St
Ste 605
Phoenix, AZ 85006
Phone (602) 239-4567

1300 N 12th St
Ste 605608
Phoenix, AZ 85006
Phone (602) 839-4567

1300 N 12th St
Ste 608
Phoenix, AZ 85006
Phone (602) 254-5321

1300 S 10th St
Phoenix, AZ 85034
Phone (602) 257-4323

1625 N 39th Ave
Phoenix, AZ 85009
Phone (602) 233-0017

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.

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1790281046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062850",
            "telephone_number": "602-839-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062850",
            "telephone_number": "602-839-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "KIANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "63498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.