Individual provider Active NPI

Kathryn J. Rose, PA-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1962567420
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2670 Issued in AZ
Practice address
7520 N Oracle Rd Ste 100
Tucson, AZ 85704-4452
Phone
(520) 408-1133
Fax
(520) 408-2233
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2670 AZ Primary

Addresses

Primary practice location

7520 N Oracle Rd Ste 100
Tucson, AZ 85704-4452

Mailing address

5055 E Broadway Blvd
Suite a-100
Tucson, AZ 85711-3640
Phone (520) 668-7318

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
I20070518000032 AZ Practitioner - Physician Assistant 9638276173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7520 N Oracle Rd
Suite 100
Tucson, AZ 85704-4452
Phone (520) 408-1133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2670AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Goldstein MD PLLC Past Accepting new patients
Daniel L. Kessler, M. D., Facp, P.L.L.C. Internal Medicine 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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1962567420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD",
            "address_2": "SUITE A-100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113640",
            "telephone_number": "520-668-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 N ORACLE RD STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044452",
            "telephone_number": "520-408-1133",
            "fax_number": "520-408-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KATHRYN",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.