Kylee Rose Tate, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

16635 N 43Rd Ave # 100
Phoenix, AZ 85053-2707

Phone

(480) 553-6168

NPI assigned

Dec 6, 2022

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

Other names 1

• Kylee Rose Humphreys Former name

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

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.

• Palo Verde Hematology Oncology LTD.

  • Hematology & Oncology Physician
  • Glendale, AZ
  • NPI 1447272372
  Medicare reassignment NPD
• Hetal C. Shah, M.D., P.C.

  dba Arizona Women's Specialists

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
  • NPI 1437189404
  Medicare reassignment
• Arizona Digestive Health, PC

  • Gastroenterology Physician
  • Scottsdale, AZ
  • NPI 1992981583
  NPD (past)
• Smriti Rana, MD, PLLC

  dba Blessings OB/GYN and Women's Care, Integrity Internal Medicine

  • Obstetrics & Gynecology Physician
  • Peoria, AZ
  • NPI 1063717213
  NPD (past)

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1306557913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16635 N 43RD AVE # 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16635 N 43RD AVE # 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532707",
            "telephone_number": "480-553-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "KYLEE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "HUMPHREYS",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corey Michael Tate, LMT
• Frances Ann Tate, GUIDANCE COUNSELOR
• Hazel Marie Tate, NURSE PRACTITIONER
• Janet Mary Tate, RNFA
• Jessica Keeler Tate, DPT, OCS
• Makenzie Tate, DO
• Sachiko Tate, LCSW
• Tylissa Tate, LCSW
• Winter Lucia Tate, DO
• Ellen Tatevosyan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.