NPIMap

Individual provider Active NPI

Phyllis Jean Kapellen, M.D.

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1922055730
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME99800 Issued in FL
Practice address
417 E Natasha CT
Tucson, AZ 85737-7383
Phone
(520) 989-9994
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35086051 OH
Diagnostic Radiology Physician 2085R0202X ME99800 FL Primary
Diagnostic Radiology Physician 2085R0202X 26030 OK
Diagnostic Radiology Physician 2085R0202X 42462-20 WI
Diagnostic Radiology Physician 2085R0202X N5147 TX

Addresses

Primary practice location

417 E Natasha CT
Tucson, AZ 85737-7383

Mailing address

417 E Natasha CT
Tucson, AZ 85737-7383
Phone (520) 989-9994

Other identifiers 1

IdentifierTypeStateIssuer
200270870AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME99800FLMDDiagnostic Radiology Physician
35086051OHMDDiagnostic Radiology Physician
N5147TXMDDiagnostic Radiology Physician
42462-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paul H Skaggs MD PA Diagnostic Radiology PastSince May 9, 1990 Accepting new patients
Indian River Radiology PA Diagnostic Radiology PastSince Mar 25, 1999 Accepting new patients
Pee Dee Orthopedic Assoc PastSince Dec 1, 1993 Accepting new patients
National Radiology Group-DFW P a Diagnostic Radiology Past Accepting new patients
Summit Medical Center Past Accepting new patients
Pee Dee Orthopedic Assoc Past Accepting new patients

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: phyllis.kapellen.1@8524.direct.athenahealth.com

Organizations & group practices 6

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1922055730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E NATASHA CT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857377383",
            "telephone_number": "520-989-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E NATASHA CT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857377383",
            "telephone_number": "520-989-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPELLEN",
        "first_name": "PHYLLIS",
        "middle_name": "JEAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35086051",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME99800",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "26030",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "42462-20",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N5147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200270870A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.