Kyra Rene Witbeck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5859 W Talavi Blvd Ste 100
Glendale, AZ 85306-1870

Phone

(602) 298-7777

Fax

(623) 930-6060

NPI assigned

Jun 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Heart PLLCGroup PAC ID 7113906421, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyra.witbeck.1@24502.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/24502/brand/1/csg/1/fhir/r4

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.

• Phoenix Heart, PLLC

  • Cardiovascular Disease Physician
  • Glendale, AZ
  • NPI 1679608095
  Medicare reassignment Care Compare group
• U Medical PLLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1821796962
  Medicare reassignment
• Phoenix Heart, PLLC

  • Cardiac Rehabilitation Registered Nurse
  • Glendale, AZ
  • NPI 1578396982
  NPD

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1104503192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5859 W TALAVI BLVD STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061870",
            "telephone_number": "602-298-7777",
            "fax_number": "623-930-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 W TALAVI BLVD STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061870",
            "telephone_number": "602-298-7777",
            "fax_number": "623-930-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 S Crismon Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852093767",
            "country_code": "US",
            "telephone_number": "480-358-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Mill Ave",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852816699",
            "country_code": "US",
            "telephone_number": "480-784-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITBECK",
        "first_name": "KYRA",
        "middle_name": "RENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Carolyn Wise, NURSE PRACTITIONER
• Wisemind Sober Living and Treatment, LLC
• Barry R Wiss, D.O.
• Emad F Wissa, MD
• Lance Reed Wissman, D.P.M.
• With Open Arms Homecare Az LLC
• Stephanie Witkemper
• Ty Robert Witt, M.D.
• Roxanne Ruth Witte, PH.D.
• Jeanne Patricia Witter, PHD, LPC, LISAC

• Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.