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MR. KEVIN LAMAR REDUS PA-C NPI 1164425633


NPI Information

NPI: 1164425633
Provider Name: MR. KEVIN LAMAR REDUS, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
3811 E BELL RD STE 309
PHOENIX, AZ
ZIP 85032
Phone: (480) 420-0749
Get Directions

MR. Kevin Lamar Redus, PA-C is a surgical physician assistant in Phoenix, AZ. MR. Kevin Lamar Redus, PA-C NPI is 1164425633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3811 E BELL RD STE 309
PHOENIX, AZ
ZIP 85032-160
Phone: (480) 420-0749
Fax: (480) 420-0732

The NPI 1164425633 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Repair of knee joint (HCPCS:27447)

The enumeration date for this NPI number is 5/27/2005 and was last updated on 7/25/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedical2477ARIZONANo
2363AS0400XPhysician AssistantSurgical2477ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
177246MEDICARE ID-TYPE UNSPECIFIEDARIZONAINDIVIDUAL MCR #
2S90338MEDICARE UPINARIZONA
3AZ0146700OTHERARIZONABLUE CROSS BLUE SHIELD AZ
4577786001MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.