MICHAEL M TALTY (P.A.) – Physician Assistant, NPI 1477513596
Physician Assistant
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHAEL M TALTY (P.A.)
2100 Powell Street, Bay Trail, Emeryville, Alameda County, California, 94608, United States
EMERYVILLE, CA 946081826
Phone: (510) 350-2664
Type: Mailing
5101 COLLEGE BLVD
LEAWOOD, KS 662111614
Phone: (913) 721-3387
Type: Mailing
706 N BURKARTH RD
WARRENSBURG, MO 640939303
Phone: (660) 747-5444
Fax: (816) 875-2597
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: 2024-09-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20050726001129 | I | Physician Assistant | CA | TBD |
| I20160113002483 | I | Physician Assistant | WA | TBD |
| I20240912003535 | I | Physician Assistant | MO | 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 94608)
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