Individual provider Active NPI

Kayla Nicole Hartman

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1629809991
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
68122 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 459-6000
NPI assigned
Aug 9, 2024
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 68122 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

PO Box 889442
Los Angeles, CA 90088-9442
Phone (559) 603-7372

Other practice location 1

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 567-6220

Other practice location 2

15 E Audubon Dr
Fresno, CA 93720-1542
Phone (559) 438-8000

Other practice location 3

2755 Herndon Ave
Clovis, CA 93611-6800
Phone (559) 324-4000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260513004504 CA Practitioner - Physician Assistant 7214406701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1601 Cummins Dr
Suite D
Modesto, CA 95358-6403

1601 Cummins Dr D
Modesto, CA 95358-6411

45 E River Park PL W
Suite 507
Fresno, CA 93720-1565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1629809991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 889442",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900889442",
            "telephone_number": "559-603-7372",
            "fax_number": "559-451-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293901",
            "country_code": "US",
            "telephone_number": "210-567-6220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Audubon Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937201542",
            "country_code": "US",
            "telephone_number": "559-438-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2755 Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936116800",
            "country_code": "US",
            "telephone_number": "559-324-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "KAYLA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "68122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.