Kevin Tiyaamornwong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 17984 Issued in CA

Practice address

505 E Almond Ave Ste 101
Madera, CA 93637-5745

Phone

(559) 664-4000

Fax

(559) 675-5224

NPI assigned

Feb 5, 2007

Last updated

Aug 6, 2025By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camarena HealthGroup PAC ID 4880584317, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madera Community Hospital Hospital, Madera, CA, CCN 050856

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.tiyaamornwong.1@25900.direct.athenahealth.com
• Direct secure messaging: kevin.tiyaamornwong@4357.securemail.prognocis.com

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.

• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
  • NPI 1891778114

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Camarena Health

  dba Camarena Health - Los Banos

  • Federally Qualified Health Center (FQHC)
  • Los Banos, CA
  • NPI 1114757754
  NPD
• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Chowchilla, CA
  • NPI 1447309885
  NPD

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

• Madera Community Hospital

  dba Family Health Services Rural Health Clinic

  • General Acute Care Hospital
  • Madera, CA
  • NPI 1669673646
  Care Compare affiliation

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1275672503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 6TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E ALMOND AVE STE 101",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375745",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIYAAMORNWONG",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 17984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA 14398",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amber Tinzly
• Derek S Tipton
• Ruetima Titapiwatanakun, M.D.
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• Edmund To, DO, MPH
• Todd Spencer MD Medical Group, Inc.
• Todd Spencer MD Medical Group, Inc.
• Andrew Toews

• Physician Assistant in Madera, CA
• Providers in Madera, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.