Individual provider Active NPI

Kimberly Ann Carter, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1851609424
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4719 Issued in AZ
Practice address
15215 S 48TH St Ste 161
Phoenix, AZ 85044-9139
Phone
(602) 633-4493
Fax
(602) 716-9656
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055465 PA
Medical Physician Assistant 363AM0700X 4719 AZ Primary

Addresses

Primary practice location

15215 S 48TH St Ste 161
Phoenix, AZ 85044-9139

Mailing address

3020 E Camelback Rd Ste 301
Phoenix, AZ 85016-4418
Phone (602) 261-9100

Other practice location 1

2222 E Highland Ave Ste 203
Phoenix, AZ 85016-4876
Phone (602) 254-5321

Other names 1

  • Kimberly Ann Casper Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101026000727 AZ Practitioner - Physician Assistant 9032302773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Digestive Health PCGroup PAC ID 6507940731, 134 clinicians

Practice addresses (Care Compare)

15215 S 48TH St
Suite 161
Phoenix, AZ 85044-9139
Phone (602) 633-4493

5823 W Eugie Ave
Suite a
Glendale, AZ 85304-1277
Phone (602) 843-1265

Merit-based Incentive Payment System (MIPS)

Final score
81.75 of 100Reported as group
Quality
60.45
Promoting interoperability
97
Improvement activities
40
Cost
81.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4719AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Savin Medical Center, PLLC Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1851609424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E CAMELBACK RD STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164418",
            "telephone_number": "602-261-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 161",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449139",
            "telephone_number": "602-633-4493",
            "fax_number": "602-716-9656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 E Highland Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164876",
            "country_code": "US",
            "telephone_number": "602-254-5321",
            "fax_number": "602-254-6528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055465",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CASPER",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.