Individual provider Active NPI

Tatyana Erdmann, P.A.

  • Physician Assistant
  • Dewey, AZ
National Provider Identifier
1073659611
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6763 Issued in AZ
Practice address
12075 E State Route 69 Ste B
Dewey, AZ 86327-4569
Phone
(928) 772-1673
Fax
(928) 772-1674
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6763 AZ Primary

Addresses

Primary practice location

12075 E State Route 69 Ste B
Dewey, AZ 86327-4569

Mailing address

12075 E State Route 69 Ste B
Dewey, AZ 86327-4569
Phone (928) 772-1673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129001672 AZ Practitioner - Physician Assistant 3375582232 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pathology Associates Current Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 10, 2018 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 10, 2018 Accepting new patients
Uhs of Pennsylvania Inc Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

1298 W Finnie Flat Rd
Ste 101
Camp Verde, AZ 86322
Phone (928) 639-5555

1298 W Finnie Flat Rd
Camp Verde, AZ 86322
Phone (928) 639-5509

340 S Willard St
Cottonwood, AZ 86326
Phone (928) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

61 Bell Rock Plz
Sedona, AZ 86351
Phone (928) 204-4999

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Healthcare Solutions LLC 199 clinicians

Practice addresses (Care Compare)

12075 E State Route 69
Dewey, AZ 86327-4517
Phone (928) 772-1673

3151 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 458-7583

3251 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-2582

3257 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-2582

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1073659611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12075 E STATE ROUTE 69 STE B",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "863274569",
            "telephone_number": "928-772-1673",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12075 E STATE ROUTE 69 STE B",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "863274569",
            "telephone_number": "928-772-1673",
            "fax_number": "928-772-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMANN",
        "first_name": "TATYANA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewey, AZ

Sources for this page

Verify at the official NPI Registry.