KACHINA FAMILY MEDICINE
NPI 1467508432
Family Medicine in Phoenix, AZ
About Kachina Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KACHINA FAMILY MEDICINE (NPI 1467508432) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since January 2007. The organization holds a CLIA Microscopy certificate valid through November 30, 2027 and lists Jaron Joseph Fischbeck, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kachina Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Kachina Family Medicine, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
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 for Provider-Performed Microscopy Procedures (PPMP) 03D0917901
Kachina Family Practice PA · Phoenix, AZFrequently 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 Kachina Family Practice PA's NPI number?
The NPI number for Kachina Family Practice PA is 1467508432. It was assigned to this organization in the NPPES registry on January 25, 2007. The provider is doing business as Kachina Family Medicine.
Where is Kachina Family Practice PA located?
Kachina Family Practice PA is located at 16611 S 40th St Suite 120, Phoenix, AZ 85048. The listed phone number is (480) 706-4100.
What is Kachina Family Practice PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kachina Family Practice PA enrolled in Medicare?
Yes. Kachina Family Practice PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kachina Family Practice PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Kachina Family Practice PA, in Family Practice and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Kachina Family Practice PA hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D0917901) is associated with this NPI, valid through November 30, 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 Kachina Family Practice PA was last updated on April 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Kachina Family Medicine · NPI 1467508432
Family Medicine organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since January 25, 2007.
## Identity
- **NPI:** 1467508432 (Entity type: Organization)
- **Enumerated:** January 25, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Kachina Family Practice Pa
- **Organization subpart:** No
- **Authorized official:** Jaron Fischbeck, PRESIDENT
## Practice location
- **Address:** 16611 S 40TH ST, SUITE 120, Phoenix, AZ 85048
- **Phone:** (480) 706-4100 · **Fax:** (480) 706-2600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 30, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1467508432) · Data from the CMS NPPES public registry.