Individual provider Active NPI

Tyler Spivey, PA-C

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1528618543
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7676 Issued in AZ
Practice address
1635 E Myrtle Ave
Phoenix, AZ 85020-5556
Phone
(026) 944-2900
NPI assigned
Sep 12, 2019
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 7676 AZ Primary

Addresses

Primary practice location

1635 E Myrtle Ave
Phoenix, AZ 85020-5556

Mailing address

1635 E Myrtle Ave
Phoenix, AZ 85020-5556
Phone (602) 944-2900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191206000541 AZ Practitioner - Physician Assistant 7416380373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Institute for Spine Care PCGroup PAC ID 1951347475, 13 clinicians

Practice addresses (Care Compare)

1635 E Myrtle Ave
Suite 400
Phoenix, AZ 85020-5514
Phone (602) 944-2900

3487 S Mercy Rd
Gilbert, AZ 85297-0432
Phone (602) 944-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.13 of 100Reported as apm
Quality
90.26
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7676AZMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tyler.spiveypac.p1@direct.sciatica.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1528618543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205556",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205556",
            "telephone_number": "026-944-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "7676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.