NPIMap

Individual provider Active NPI

Kaitlin Buss, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1962915942
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6973 Issued in AZ
Practice address
4137 N 108TH Ave
Phoenix, AZ 85037-5459
Phone
(623) 877-7337
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 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 6973 AZ Primary

Addresses

Primary practice location

4137 N 108TH Ave
Phoenix, AZ 85037-5459

Mailing address

4137 N 108TH Ave
Phoenix, AZ 85037-5459
Phone (623) 877-7337

Other practice location 1

890 W Elliot Rd Ste 102
Gilbert, AZ 85233-5127
Phone (480) 500-2285

Other practice location 2

9160 W Calavar Rd
Peoria, AZ 85381-3568
Phone (602) 616-2821

Other names 1

  • Kaitlin Marie Pawlowski Former name

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6973AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Desert Valley Pediatrics PastSince Aug 7, 2022 Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Texan Urgent Care PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Whispering Palms Medical Inc Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients

Organizations & group practices 9

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1962915942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 N 108TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375459",
            "telephone_number": "623-877-7337",
            "fax_number": "623-772-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4137 N 108TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375459",
            "telephone_number": "623-877-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 W Elliot Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852335127",
            "country_code": "US",
            "telephone_number": "480-500-2285",
            "fax_number": "919-882-9575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9160 W Calavar Rd",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853813568",
            "country_code": "US",
            "telephone_number": "602-616-2821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSS",
        "first_name": "KAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "PAWLOWSKI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.