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

Mr. Kendall Philip Smith, PA

Individual provider Physician Assistant · NPI 1366936833

Mr. Kendall Philip Smith, PA is a Physician Assistant in Phoenix, Arizona. Qualified in 2018, 8 years ago. Practices with Center for Dermatology PLLC, a 69-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
8
Licensed in
IN
In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4425 E Agave Rd Ste 148
Phoenix, AZ 85044-0623
Phone: (480) 704-7546
Fax: (480) 704-7549
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (IN)

Record details

NPI number1366936833
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 19, 2018
Last updated in NPPESApril 17, 2024
Certification dateApril 17, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Center For Dermatology Pllc — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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