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KYLE MAXUM
NPI 1225805211
Physician Assistant in Fort Defiance, AZ

Active since December 08, 2023PECOS Enrolled
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504(928) 729-8000 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 12, 2024, Dec 8, 2023 (2 updates tracked since 2023).

About Kyle Maxum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE MAXUM (NPI 1225805211) is an individual physician assistant in Fort Defiance, Arizona, licensed in Colorado (PA.0008848) and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225805211
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKYLE MAXUM
Location AddressCORNER OF ROUTE N12 AND N7Fort Defiance, AZ 86504
Mailing AddressPo Box 649Fort Defiance, AZ 86504-0649
Phone(928) 729-8000
Sole ProprietorNo
Enumeration DateDecember 8, 2023
Last NPPES UpdateNovember 12, 20242 updates tracked since enumeration
NPPES CertifiedNovember 8, 2024
✔ NPI 1225805211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CO · PA.0008848
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
CORNER OF ROUTE N12 AND N7, Fort Defiance, AZ 86504
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kyle Maxum is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. ROMULO LAURETA PARUNGAO M.D.
Emergency Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8600
JAY S GUIKEMA FNP
Nurse Practitioner (Family)
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
MARIBEL PASTRAN RD, CD
Dietitian, Registered
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
PONY NANCY SOKIRI PA-C
Physician Assistant
CORNER OF ROUTE N12 AND N7, CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
SARAH R WILLIAMS PT
Physical Therapist
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
JOHN NORBERT
Family Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
DR. LINDA BROWN TRUDEL MD
Family Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
DR. SAMMIE MICHEAL BIA III PHARMD.
Pharmacist
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000

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 Maxum's NPI number?

The NPI number for Kyle Maxum is 1225805211. It was assigned to this individual provider in the NPPES registry on December 8, 2023.

Where is Kyle Maxum located?

Kyle Maxum practices at Corner Of Route N12 And N7, Fort Defiance, AZ 86504. The listed phone number is (928) 729-8000.

What is Kyle Maxum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kyle Maxum enrolled in Medicare?

Yes. Kyle Maxum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kyle Maxum was last updated on November 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.