KEVIN SY
NPI 1083401301
Nurse Practitioner - Family in Glendale, AZ

Q: What is Kevin Sy's NPI number?

The NPI number for Kevin Sy is 1083401301. It was assigned to this individual provider in the NPPES registry on April 21, 2025.

Q: What is Kevin Sy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Sy was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.

Active since April 21, 2025PECOS EnrolledAccepts Medicare Assignment

5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302(623) 387-3705(623) 439-7467 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Kevin Sy NPPES

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

KEVIN SY (NPI 1083401301) is an individual family provider in Glendale, Arizona, licensed in Arizona (322427) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083401301

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameKEVIN SY

Location Address5700 W OLIVE AVE STE 102Glendale, AZ 85302-3147

Mailing Address5700 W Olive Ave Ste 102Glendale, AZ 85302-3147 · (623) 387-3705 · Fax (623) 439-7467

Phone(623) 387-3705

Fax(623) 439-7467

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 21, 2025

NPPES CertifiedApril 18, 2025

✔ NPI 1083401301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · 322427

5700 W OLIVE AVE STE 102, Glendale, AZ 85302

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Sy is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42711814

PECOS Enrollment IDI20250902003516

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kevin Sy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

I-Med P C

Same address

Internal Medicine

5700 W OLIVE AVE # 2102
Glendale, AZ 85302

Reassigned Medicare billing, Arizona enrollment
2 clinicians in this Medicare group

NPI 1093996589 (623) 580-6968

The Wellness And Prevention Center, LLC

Same address

Family

5700 W OLIVE AVE STE 102
Glendale, AZ 85302

Reassigned Medicare billing, Arizona enrollment
3 clinicians in this Medicare group

NPI 1881974731 (623) 387-3705

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85302 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALODIA BANUELOS DOMINGO NP

Nurse Practitioner (Family)