Individual provider Active NPI

Brit Sumner Hatch, PA-C

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1073934568
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20473 Issued in TX
Practice address
1367 Dominion PLZ
Tyler, TX 75703-1013
Phone
(903) 534-6200
Fax
(903) 939-0755
NPI assigned
Dec 30, 2013
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA20473 TX Primary

Addresses

Primary practice location

1367 Dominion PLZ
Tyler, TX 75703-1013

Mailing address

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

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
I20140306001922 AZ Practitioner - Physician Assistant 8022248335 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Donsky Bogle Dermatology LLCGroup PAC ID 6608930763, 7 clinicians

Practice addresses (Care Compare)

1150 N Country Club Dr
6 Grand Canyon Derm PLLC
Mesa, AZ 85201-2537
Phone (480) 962-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5616AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. CurrentSince Aug 3, 2026 Accepting new patients
Clin-Path Pathology PastSince May 11, 2025 Accepting new patients
Dermatology Associates PastSince Aug 3, 2026 Accepting new patients

Locations

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

1720 S Beckham Ave
Ste 102
Tyler, TX 75701
Phone (903) 534-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1073934568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 DOMINION PLZ",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031013",
            "telephone_number": "903-534-6200",
            "fax_number": "903-939-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 DOMINION PLZ",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031013",
            "telephone_number": "903-534-6200",
            "fax_number": "903-939-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "BRIT",
        "middle_name": "SUMNER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-30",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA20473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.