Tyler Pemberton, PMHNP

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

313307 Issued in AZ

Practice address

334 W 10TH PL Ste 100
Mesa, AZ 85201-3499

Phone

(602) 258-6797

Fax

(602) 254-2636

NPI assigned

Aug 23, 2024

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valle del Sol, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1831344035
  Medicare reassignment NPD
• Valle del Sol, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1174345839
  NPD
• Empact Suicide Prevention Center Inc

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1659414969
  NPD (past)

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1639902679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5226 S DREXEL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128511",
            "telephone_number": "602-258-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 W 10TH PL STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013499",
            "telephone_number": "602-258-6797",
            "fax_number": "602-254-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "TYLER",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "313307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Peller, O.D.
• Angela Pelletier, DMD
• Anabelle Pelto
• Pema Dental Center Inc
• Rakesh Dhiru Pema, D.D.S.
• Jesus Pena Nunez, STUDENT
• Crystal Pena, CPM, LM
• Izabel Anamaria Pena, M.S., CCC-SLP
• Jennifer K. Pena
• Liceett Pena, FNP-C

• Psychiatry Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.