Michael W Kipp, MMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5277 Issued in AZ

Practice address

18511 N Scottsdale Rd Ste 202
Scottsdale, AZ 85255-9694

Phone

(480) 306-7242

NPI assigned

Oct 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.kipp@sep.eclinicaldirectplus.com

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.

• Innovative Pain and Wellness PLC

  • Interventional Pain Medicine Physician
  • Scottsdale, AZ
  • NPI 1659812444
  Medicare reassignment NPD
• Palo Verde Family Medicine PLLC

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1417222969
  NPD (past)
• We Care Urgent Care Centers PLLC

  • Urgent Care Clinic/Center
  • Peoria, AZ
  • NPI 1093034589
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1841544764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18511 N SCOTTSDALE RD STE 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852559694",
            "telephone_number": "480-306-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 N SCOTTSDALE RD STE 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852559694",
            "telephone_number": "480-306-7242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1921 S Alma School Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852103037",
            "country_code": "US",
            "telephone_number": "480-573-0414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8110 W Union Hills Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853088181",
            "country_code": "US",
            "telephone_number": "480-306-7242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22601 N 19th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850271324",
            "country_code": "US",
            "telephone_number": "623-231-2443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2340 E Beardsley Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850241286",
            "country_code": "US",
            "telephone_number": "480-306-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIPP",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2022-11-04",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757438",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.kipp@sep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1277 E Missouri Ave Ste 102",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850142916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Spencer Kingston, M.D.
• Tiffany Reyes Kinkade, PT, DPT
• Carolyn L Kinney, MD
• Kinob Care LLC
• Krista Lynn Kipp, PHARMD
• Ashley Michelle Kirby-Ward
• Jayson Arthur Kirchhofer, D.M.D., M.D.
• Amy Kirchner, MS, CCC-SLP
• Edilena L Kirchner, LAC
• Robert William Kirchoff, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.