Demiana Marie Kolta, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9992 Issued in AZ

Practice address

14445 W McDowell Rd Ste A104
Goodyear, AZ 85395-2518

Phone

(480) 561-5000

Fax

(480) 984-4066

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Innovative Pain and Wellness PLCGroup PAC ID 0840567111, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovative Pain and Wellness PLC

  • Interventional Pain Medicine Physician
  • Scottsdale, AZ
  • NPI 1659812444
  Medicare reassignment Care Compare group NPD
• Canyon Pain and Spine

  • Pain Medicine Physician
  • Mesa, AZ
  • NPI 1518547769
  Medicare reassignment NPD
• Innovative Pain and Wellness PLC

  • Pain Medicine (Anesthesiology) Physician
  • Scottsdale, AZ
  • NPI 1396428009

  Physician Assistant

  NPD

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1821709833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 W MCDOWELL RD STE A104",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952518",
            "telephone_number": "480-561-5000",
            "fax_number": "480-984-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 W MCDOWELL RD STE A104",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952518",
            "telephone_number": "480-561-5000",
            "fax_number": "480-984-4066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6320 W Union Hills Dr Ste A270",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853087175",
            "country_code": "US",
            "telephone_number": "480-561-5000",
            "fax_number": "480-984-4066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLTA",
        "first_name": "DEMIANA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Maria Kogut, RN
• Lonnie W Kohl, PA
• Brendan Koistinen, DO
• Kokoro Transitional Recovery and Counseling Services
• Alicia Kolbeck, M.S., OTR/L
• Amber Lynn Konen, PHARMD
• Veronica Kongnyuy
• Stefanie Marie Kool, PSY.D.
• Danielle Kopas, FNP-C
• James Kosier, LDO

• Physician Assistant in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.