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

Kyle Tisi

Individual provider Family Medicine Physician · NPI 1366813602

Kyle Tisi is a Physician Assistant in Gilbert, Arizona. Qualified in 2015, 11 years ago. Practices with Hamblin Dermatology PLLC, a 7-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
11
Licensed in
AZ
In the registry since
2015
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Practice location Address checks out

1489 S Higley Rd Ste 101
Gilbert, AZ 85296-4777
Phone: (480) 457-8800
Fax: (480) 457-8885
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 6212 (AZ)

Record details

NPI number1366813602
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2015
Last updated in NPPESOctober 19, 2015
Mailing address1489 S Higley Rd, 101, Gilbert, AZ 85296-4776

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Hamblin Dermatology Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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