Kiana Espinosa, MD
Individual provider Active NPI Family Medicine Physician · Phoenix, AZ
NPI 1790281046 · NPPES record last updated Oct 17, 2022
Key facts
- NPI
- 1790281046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 63498 (AZ)
- Practice address
- 1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850 - Phone
- (602) 839-4567
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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 LLC
Practice addresses (Care Compare)
1300 N 12TH St
Suite 605
Phoenix, AZ 85006-2850
Phone (602) 839-4567
Hospital & facility affiliations
- Banner - University Medical Center Phoenix
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210817004127 | AZ | Practitioner - Family Practice | 1355693896 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner -- University Primary Care Physicians LLC | Current |
Accepting new patients | |
| Wesley Community Center Inc | Current |
Accepting new patients | |
| Wesley Community Center Inc | Current | Accepting new patients | |
| Wesley Community Center, Inc | Current |
Accepting new patients | |
| Banner - University Medical Center Phoenix | Past | Accepting new patients |
Locations
1300 S 10th St
Phoenix, AZ 85034
Phone (602) 257-4323
1300 N 12th St
Ste 605
Phoenix, AZ 85006
Phone (602) 239-4567
1625 N 39th Ave
Phoenix, AZ 85009
Phone (602) 233-0017
1300 N 12th St
Ste 608
Phoenix, AZ 85006
Phone (602) 254-5321
1300 N 12th St
Ste 605608
Phoenix, AZ 85006
Phone (602) 839-4567
1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 63498 | AZ | Yes |
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
Other providers in Phoenix, AZ
- Celia Camila Espino Lazo
- Lora Michelle Espino
- Shannon Michelle Espinosa Hernandez
- Aurelio Espinosa
- Jocelyn S. Espinosa
- Monica Margaret Espinosa
- Ray Anthony Espinosa
- Renee Diane Espinosa
- Gabriela Thais Espinoza Carrasco
- Alesandra Marie Espinoza
All providers in Phoenix, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.