Kierstin Lealiiee, is a medicare enrolled "Family Medicine" in Gold Canyon, Arizona. Her current practice location is
6410 S Kings Ranch Rd Ste 1, Gold Canyon, Arizona. You can reach out to her office (for appointments etc.) via phone at
(480) 761-2500.
Kierstin Lealiiee is licensed to practice in Arizona (license number 10838) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124644182.
Provider's Profile
| Full Name | Kierstin Lealiiee |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 6410 S Kings Ranch Rd Ste 1, Gold Canyon, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1124644182
- Provider Enumeration Date: 06/24/2020
- Last Update Date: 02/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 1254751043
- Enrollment ID: I20201016000360
Medical Identifiers
Medical identifiers for Kierstin Lealiiee such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124644182 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | PA2437 (Nevada) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 11959125-1206 (Utah) | Secondary |
| 207Q00000X | Family Medicine | 10838 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kierstin Lealiiee allows following entities to bill medicare on her behalf.
| Entity Name | St George Eye Center Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073996344
PECOS PAC ID: 9234445065
Enrollment ID: O20150825003368 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kierstin Lealiiee is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kierstin Lealiiee,
219 N 2940 E,
St George, UT 84790-7096
Ph: (602) 489-1313 | Kierstin Lealiiee,
6410 S Kings Ranch Rd Ste 1,
Gold Canyon, AZ 85118-7352
Ph: (480) 761-2500 |
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