Kylee Juleene Brennan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8322 Issued in AZ

Practice address

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Phone

(602) 734-5238

NPI assigned

Mar 8, 2021

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optima Medical Care LLCGroup PAC ID 2062572563, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Optima Medical Care, LLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1235380007
  Medicare reassignment Care Compare group
• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257
  Medicare reassignment NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Sun City, AZ
  • NPI 1770139958
  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708
  Medicare reassignment
• Banner Imaging Services LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1710733472
  NPD
• Eagle Partners, PLLC

  • Diagnostic Radiology Physician
  • Duncan, OK
  • NPI 1548450976
  NPD (past)

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1831784263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 W EUGIE AVE STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041273",
            "telephone_number": "602-734-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-734-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KYLEE",
        "middle_name": "JULEENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breezy Mendoza NP LLC
• Patricia Ann Bregar, RN BSN
• Angela Marie Breitmeyer, PSY.D.
• Jan H Brekke, MD
• Abigail Breland
• Selena Maree Brennan, ATC
• Brent P Hansen DO PC
• Clara Brewer
• Lena M Brewer, MS, OTR/L
• Brian a Tolman DMD PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.