Active NPI
Kyle Tisi
- Family Medicine Physician
- Gilbert, AZ
National Provider Identifier
1366813602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 6212
- Practice address
- 1489 S. Higley Rd
Suite 101
Gilbert, AZ 85296-4777 - Phone
- (480) 457-8800
- Fax
- (480) 457-8885
- NPI assigned
- Oct 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 6212 | AZ | Primary |
Addresses
Primary practice location
1489 S. Higley Rd
Suite 101
Gilbert, AZ 85296-4777
Mailing address
1489 S Higley Rd
101
Gilbert, AZ 85296-4776
Phone (480) 457-8800
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 N Broad St
Suite E
Globe, AZ 85501-2700
Phone (928) 532-7546
5300 S Sutter Dr
Suite 1
Show Low, AZ 85901-8055
Phone (928) 532-7546
7400 S Power Rd
Suite 118
Gilbert, AZ 85297-9283
Phone (928) 532-7546
796 S 20TH Ave
Thatcher, AZ 85552-4424
Phone (928) 424-7546
Hospital & facility affiliations
- Mt. Graham Regional Medical Center
- Cobre Valley Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6212 | AZ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Heart Specialists PLLC | Past | Accepting new patients | |
| HW Dermatology PLLC | Past | Accepting new patients |
Interoperability endpoints
- kyle.tisi@mfamd-az.direct.office.nextgen.com
Organizations & group practices 4
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.
-
- Dermatology Physician
- Show Low, AZ
- NPI 1568851350
-
- Emergency Medical Services (Emergency Medicine) Physician
- Tolleson, AZ
- NPI 1891888517
-
- Cardiovascular Disease Physician
- Lakeside, AZ
- NPI 1750513438
-
- Dermatology Physician
- Mesa, AZ
- NPI 1750800033
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Globe, AZ
- NPI 1871566521
-
- Critical Access Hospital
- Safford, AZ
- NPI 1275588345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1366813602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1489 S HIGLEY RD",
"address_2": "101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852964776",
"telephone_number": "480-457-8800",
"fax_number": "480-457-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1489 S. HIGLEY RD",
"address_2": "SUITE 101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852964777",
"telephone_number": "480-457-8800",
"fax_number": "480-457-8885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISI",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "6212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.