Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle Justin Mesa, PA-C

Individual provider Physician Assistant · NPI 1114633153

Kyle Justin Mesa, PA-C is a Physician Assistant in Brooklyn, New York. Qualified in 2022, 4 years ago. Registered with an NPI since 2023.

Years since qualifying
4
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone: (631) 991-5010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1114633153
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 24, 2023
Last updated in NPPESJanuary 24, 2023
Certification dateJanuary 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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