Jacob Kirkeeng, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

724 N Montezuma St Ste a
Prescott, AZ 86301-2066

Phone

(928) 925-2871

NPI assigned

Apr 29, 2015

Last updated

Mar 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: jacobkirkeeng@leadingedgehealthcare.kareodirect.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.

• Leading Edge Healthcare, PLLC

  • General Practice Physician
  • Prescott, AZ
  • NPI 1659017499
  Medicare reassignment Authorized official
• Eric Baumann MD, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Prescott, AZ
  • NPI 1588620421
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yavapai Community Hospital Association

  dba Yavapai Regional Medical Center

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1881071751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N MONTEZUMA ST STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N MONTEZUMA ST STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012066",
            "telephone_number": "928-925-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKEENG",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian D Kimball, MD
• Kathryn Kimball, R.D.
• Naomi King
• Mohamed A Kirdani, M.D.
• Kim Kirk
• Dean Kirschbaum, D.O.
• Julia Kiss, PHARMD
• Allison Jane Kitchens, LMSW
• Carol Klein, MD
• Shelly Faye Klein, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.