Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kyra Rene Witbeck, PA-C

Individual provider Physician Assistant · NPI 1104503192

Kyra Rene Witbeck, PA-C is a Physician Assistant in Glendale, Arizona. Qualified in 2023, 3 years ago. Practices with Phoenix Heart PLLC, a 19-clinician group, works from 3 locations and accepts Medicare assignment.

Years since qualifying
3
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

5859 W Talavi Blvd Ste 100
Glendale, AZ 85306-1870
Phone: (602) 298-7777
Fax: (623) 930-6060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1301 S Crismon Rd, Mesa, AZ 85209-3767 — (480) 358-6100
  • 1500 S Mill Ave, Tempe, AZ 85281-6699 — (480) 784-5500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104503192
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 30, 2023
Last updated in NPPESNovember 20, 2024
Certification dateNovember 20, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Phoenix Heart Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Glendale