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PINEAPPLE HEALTH
NPI 1063640977
Family Medicine in Phoenix, AZ

Active since June 30, 2009CLIA 03D0894608 · Waiver
12010 S WARNER ELLIOT LOOP STE 1, PHOENIX, AZ 85044(480) 961-2366(480) 961-2367 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Pineapple Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINEAPPLE HEALTH (NPI 1063640977) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through May 10, 2027, maintains a secondary practice location in Prescott Valley, and lists Kevin Yin Shun Chan, Owner, as its authorized official.

NPPES Registry Identity

NPI1063640977
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDR KEVIN CHAN PC
Location Address12010 S WARNER ELLIOT LOOP STE 1Phoenix, AZ 85044-2731
Mailing Address12010 S Warner Elliot Loop Ste 1Phoenix, AZ 85044-2731 · (480) 961-2366 · Fax (480) 961-2367
Phone(480) 961-2366
Fax(480) 961-2367
Organization SubpartNo
Authorized OfficialKevin Yin Shun ChanOwner · (480) 577-8199
Enumeration DateJune 30, 2009
Last NPPES UpdateJuly 7, 2022
NPPES CertifiedJuly 7, 2022
✔ NPI 1063640977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12010 S WARNER ELLIOT LOOP STE 1, Phoenix, AZ 85044
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Other Names 2

Doing Business AsPineapple Health
Doing Business AsPineapple Health Pv

Secondary Practice Location 1

Location 13196 N Windsong DrPrescott Valley, AZ 86314-2239 · Phone (928) 772-1505 · Fax (928) 772-6343

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pineapple Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Pineapple Health, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Kevin Chan, DO
Family Practice
NPI 1528014248
12010 S WARNER ELLIOT LOOP STE 1
Phoenix, AZ 85044
(480) 961-2366
✔ PECOS✔ Accepts MedicareSame address
Jonne Housh, MSN, NP-C
Nurse Practitioner
NPI 1285847210
12010 S WARNER ELLIOT LOOP SUITE 1A
Phoenix, AZ 85044
(480) 961-2366
✔ PECOSSame address
Jennifer Lopez
Nurse Practitioner
NPI 1326496597
12010 S WARNER ELLIOT LOOP
Phoenix, AZ 85044
(480) 961-2366
✔ PECOSSame address
Kerry Oliver, FNP-C
Nurse Practitioner
NPI 1306341748
12010 S WARNER ELLIOT LOOP STE 1
Phoenix, AZ 85044
(480) 961-2366
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0894608

Pineapple Health · Phoenix, AZ
Active · expires May 10, 2027
CLIA Number03D0894608
Laboratory TypePhysician Office
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorKevin Chan
Laboratory Phone(480) 961-2366
Laboratory LocationPineapple Health12010 S Warner-Elliot Loop, Ste 1, Phoenix, AZ 85044
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr Kevin Chan PC's NPI number?

The NPI number for Dr Kevin Chan PC is 1063640977. It was assigned to this organization in the NPPES registry on June 30, 2009. The provider is doing business as Pineapple Health and Pineapple Health PV.

Where is Dr Kevin Chan PC located?

Dr Kevin Chan PC is located at 12010 S Warner Elliot Loop Ste 1, Phoenix, AZ 85044. The listed phone number is (480) 961-2366.

What is Dr Kevin Chan PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dr Kevin Chan PC enrolled in Medicare?

Yes. Dr Kevin Chan PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dr Kevin Chan PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Dr Kevin Chan PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Family Practice (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dr Kevin Chan PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0894608) is associated with this NPI, valid through May 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dr Kevin Chan PC was last updated on July 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.