KYLE KATAYAMA (PA) – Physician Assistant, NPI 1194595538

KYLE KATAYAMA (PA) is a healthcare provider. based in Hawthorne, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA67403 (CA). The NPI Number for KYLE KATAYAMA (PA) is 1194595538

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
KYLE KATAYAMA (PA)
NPI
1194595538
Phone
(323) 306-9632
Address
14650 AVIATION BLVD STE 200
Enumeration Date
8 January 2024
Last Update Date
30 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3233069632
Graduation Year
2025 (1 year ago)
PAC ID
7719463686
Group Practice PAC ID
1759607310
Professional Enrollment ID
I20260109002531
Address ID
CA908133422LO1045XAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

Provider Addresses for KYLE KATAYAMA (PA)

  • 14650 AVIATION BLVD STE 200

    HAWTHORNE, CA 902506670

    Phone: (323) 306-9632

    Fax: (323) 268-6738

    Type: Mailing

  • 1045 ATLANTIC AVE STE 505

    LONG BEACH, CA 908133422

    Phone: (323) 306-9632

    Fax: (323) 268-6738

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2026-01-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260109002531IPhysician AssistantCATBD

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.

Verify on CMS Revalidation Lookup Tool

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 90250)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759607310View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YCA
Physician AssistantCA
O T O L A R Y N G O L O G YGA
O T O L A R Y N G O L O G YCA
Otolaryngology, Plastic And Reconstructive SurgeryIL
O T O L A R Y N G O L O G YCA
O T O L A R Y N G O L O G YCA
Sleep Medicine, Family PracticeCA
O T O L A R Y N G O L O G YPA
O T O L A R Y N G O L O G YCA

Reviews

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Frequently asked questions

Does KYLE KATAYAMA (PA) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KYLE KATAYAMA (PA) uses 1194595538.
Does CMS list KYLE KATAYAMA (PA) as active?
Yes — KYLE KATAYAMA (PA) is active in the NPI listing used on this page.
What is KYLE KATAYAMA (PA)'s primary classification?
Physician Assistant is the headline specialty for KYLE KATAYAMA (PA) here. Clinical services aligned with this taxonomy classification.
Does KYLE KATAYAMA (PA) list a practice location?
Patients near Hawthorne, California may find KYLE KATAYAMA (PA) in results; validate coverage separately.
Is the information about KYLE KATAYAMA (PA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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