KYRA RENE WITBECK (PA-C) – Physician Assistant, NPI 1104503192
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,685 PHYSICIAN ASSISTANT in AZ
Provider Addresses for KYRA RENE WITBECK (PA-C)
1301 S Crismon Rd
Mesa, AZ 852093767
Phone: (480) 358-6100
Type: Location
1500 S Mill Ave
Tempe, AZ 852816699
Phone: (480) 784-5500
Type: Location
5859 W TALAVI BLVD STE 100
GLENDALE, AZ 853061870
Phone: (602) 298-7777
Fax: (623) 930-6060
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $1,047.
Total Amount is formed as General ($1,047) + Research ($0) + Ownership ($0) = $1,047.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($197).
Total Amount
$1,047
General + Research + Ownership
Payments
30
Total payment records
General Amount
$1,047
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-09-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230905002786 | I | Physician Assistant | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 85209)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Cardiovascular Disease (Cardiology), Cardiac Electrophysiology | AZ | |
| Cardiovascular Disease (Cardiology) | CO | |
| Cardiovascular Disease (Cardiology) | AZ | |
| Cardiovascular Disease (Cardiology) | AZ | |
| Cardiovascular Disease (Cardiology), Internal Medicine | AZ | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | CA | |
| Cardiovascular Disease (Cardiology) | AZ | |
| Nurse Practitioner | AZ |
Reviews
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