Kyle Deacy

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10917 Issued in AZ

Practice address

2800 E Ajo Way
Tucson, AZ 85713-6204

Phone

(520) 870-2000

NPI assigned

Oct 9, 2024

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  Medicare reassignment
• Banner-University Medical Group

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1932708328
  NPD

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1235958992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "715-610-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-870-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACY",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Marie De Stefano, R.P.A.-C.
• Marcus Aurelius De Volder
• Brannan M De Voto Noonan
• Elizabeth De Vries, M.S.
• Mark Deacon
• Jessica Deahl, L.AC.
• Rachel Erin Deal, RD, CSOWM
• Sheldon C Deal
• Dean J. Limbert, M.D. Inc.
• Gayle A Dean, MD

• Medical Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.