Individual provider Active NPI

Kasimu Frank Kalala, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1912568908
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234713 Issued in AZ
Practice address
1807 W Van Buren St
Phoenix, AZ 85007-2468
Phone
(480) 660-5913
NPI assigned
Jun 21, 2019
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142884 TX
Family Nurse Practitioner 363LF0000X 234713 AZ Primary

Addresses

Primary practice location

1807 W Van Buren St
Phoenix, AZ 85007-2468

Mailing address

PO Box 96770
Phoenix, AZ 85072-6770
Phone (480) 660-5913

Other practice location 1

US 191 & Az 264
Ganado, AZ 86505
Phone (928) 755-4632

Other practice location 2

3902 Impatiens Vw
San Antonio, TX 78245-2961
Phone (210) 307-5387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240217000741 AZ Practitioner - Nurse Practitioner 3577992908 Reassigns benefits to 2 organizations
I20240222003541 NM Practitioner - Nurse Practitioner 3577992908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Navajo Health Foundation-Sage Memorial Hospital, Inc.Group PAC ID 2163332347, shared by 3 NPIs, 60 clinicians

Practice addresses (Care Compare)

State Hwy 264 JCT Hwy 191
Ganado, AZ 86505-0457
Phone 92875545004933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
234713AZMDFamily Nurse Practitioner
AP142884TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hidalgo Medical Services Current Accepting new patients
Hidalgo Medical Services CurrentSince Jan 18, 2024 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Feb 18, 2025 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Feb 18, 2025 Accepting new patients
Hidalgo Medical Services CurrentSince Jan 18, 2024 Accepting new patients
In-Line Health Clinic Current Accepting new patients
Corner Health Medical Group P a Family Past Accepting new patients

Locations

1807 W Van Buren St
Phoenix, AZ 85007
Phone (480) 397-1379

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2369

1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1912568908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96770",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850726770",
            "telephone_number": "480-660-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850072468",
            "telephone_number": "480-660-5913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "US 191 & AZ 264",
            "address_purpose": "LOCATION",
            "city": "Ganado",
            "state": "AZ",
            "postal_code": "86505",
            "country_code": "US",
            "telephone_number": "928-755-4632",
            "fax_number": "928-755-4831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3902 Impatiens Vw",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782452961",
            "country_code": "US",
            "telephone_number": "210-307-5387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALALA",
        "first_name": "KASIMU",
        "middle_name": "FRANK",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142884",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "234713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.