Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Perry, PAS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063031938

Kenneth Perry, PAS is a Physician Assistant in Phoenix, Arizona. Qualified in 2020, 6 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

435 N 5th St
Phoenix, AZ 85004-2157
Phone: (602) 827-2450
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1063031938
Entity typeIndividual (Type 1)
GenderMale
Credentials PAS
Sole proprietorYes
NPI enumeratedApril 10, 2020
Last updated in NPPESApril 10, 2020
Certification dateApril 10, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Phoenix