Individual provider Active NPI

Brian Kummet, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1801266218
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6189 Issued in AZ
Practice address
4117 N 17TH St
Phoenix, AZ 85016-5921
Phone
(480) 341-5174
Fax
(480) 781-4524
NPI assigned
Sep 28, 2015
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6189 AZ Primary

Addresses

Primary practice location

4117 N 17TH St
Phoenix, AZ 85016-5921

Mailing address

4117 N 17TH St
Phoenix, AZ 85016-5921
Phone (480) 440-2886

Other practice location 1

350 W Thomas Rd
Phoenix, AZ 85013-4496
Phone (602) 406-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20151116002372 AZ Practitioner - Physician Assistant 9234449547 Reassigns benefits to 2 organizations
I20160219000321 TX Practitioner - Physician Assistant 9234449547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower St Josephs PLLCGroup PAC ID 2961866173, 52 clinicians

Practice addresses (Care Compare)

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Arizona, PC CurrentSince Jan 4, 2016 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Dec 29, 2015 Accepting new patients
Cep America - Arizona PC CurrentSince Jan 4, 2016 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

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 4

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": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1801266218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 N 17TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165921",
            "telephone_number": "480-440-2886",
            "fax_number": "480-781-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 N 17TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165921",
            "telephone_number": "480-341-5174",
            "fax_number": "480-781-4524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134496",
            "country_code": "US",
            "telephone_number": "602-406-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMMET",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.