KYLE DAVID TUCKER RN
NPI 1104706365
Nurse Practitioner in Thousand Oaks, CA
About Kyle David Tucker Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYLE DAVID TUCKER RN (NPI 1104706365) is an individual nurse practitioner in Thousand Oaks, California, licensed in California (95039691) and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2026).
NPPES Registry Identity
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kyle David Tucker Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kyle Tucker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Delano, CA 93215
- Reassigned Medicare billing, California enrollment
- 301 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91360 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
THOUSAND OAKS, CA 91360
THOUSAND OAKS, CA 91360
THOUSAND OAKS, CA 91360
THOUSAND OAKS, CA 91360
THOUSAND OAKS, CA 91360
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kyle Tucker's NPI number?
The NPI number for Kyle Tucker is 1104706365. It was assigned to this individual provider in the NPPES registry on September 6, 2025.
Where is Kyle Tucker located?
Kyle Tucker practices at 215 W Janss Rd, Thousand Oaks, CA 91360. The listed phone number is (805) 370-4436.
What is Kyle Tucker's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Kyle Tucker enrolled in Medicare?
Yes. Kyle Tucker is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kyle Tucker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kyle Tucker reassigns Medicare benefits to Team Physicians Of California Medical Group Inc (Delano, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyle Tucker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kyle Tucker was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kyle David Tucker, RN · NPI 1104706365
Nurse Practitioner physician in Thousand Oaks, California. Individual provider, active in the CMS NPPES registry since September 6, 2025.
## Identity
- **NPI:** 1104706365 (Entity type: Individual)
- **Enumerated:** September 6, 2025
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 95039691 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 215 W JANSS RD, Thousand Oaks, CA 91360-1847
- **Phone:** (805) 370-4436
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Team Physicians Of California Medical Group Inc (NPI 1447288345, Delano, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2026
## Record status
- **NPPES last updated:** October 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104706365) · Data from the CMS NPPES public registry.