Active NPI
Jasmine Dominique Kalili, PA-C
- Physician Assistant
- Sun City West, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9570
- Practice address
- 14520 W Granite Valley Dr Ste 210
Sun City West, AZ 85375-5855 - Phone
- (866) 974-2673
- Fax
- (866) 939-2673
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601001358 | MI | |
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 9570 | AZ | Primary |
Addresses
Primary practice location
14520 W Granite Valley Dr Ste 210
Sun City West, AZ 85375-5855
Mailing address
18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (669) 742-6738
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162801 | Medicaid | AZ | |
| 2000017753 | Other | BOARD OF CERTIFICATION | |
| 2601001358 | Other | MI | MI DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.65 of 100
- Quality
- 76.23
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.95
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9570 | AZ | MD | Physical Therapist |
| 2601001358 | MI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Orthopedic Research and Education, LLC | Physician Assistant | Current | Accepting new patients |
Locations
18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738
18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706
10484 W Thunderbird Blvd
Ste 100
Sun City, AZ 85351
Phone (669) 742-6738
10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1427095801
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1932639788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18444 N 25TH AVE STE 310",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850231266",
"telephone_number": "669-742-6738",
"fax_number": "866-939-2673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14520 W GRANITE VALLEY DR STE 210",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853755855",
"telephone_number": "866-974-2673",
"fax_number": "866-939-2673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALILI",
"first_name": "JASMINE",
"middle_name": "DOMINIQUE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601001358",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "9570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162801",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION",
"identifier": "2000017753",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
"identifier": "2601001358",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sun City West, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.