MR. WYATT RANDOLPH EDDY MS, MMS, PA-C
NPI 1285016394
Physician Assistant - Medical in Kingman, AZ

Q: What is Wyatt Eddy's NPI number?

The NPI number for Wyatt Eddy is 1285016394. It was assigned to this individual provider in the NPPES registry on June 25, 2015.

Q: What is Wyatt Eddy's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Wyatt Eddy was last updated on December 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since June 25, 2015PECOS Enrolled

83.2/100

CMS Quality Rating

3269 STOCKTON HILL RD, KINGMAN, AZ 86409(928) 757-2101 Get Directions Write a Review

NPPES record last updated: December 23, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mr. Wyatt Randolph Eddy Ms, Mms, Pa-c NPPES

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

MR. WYATT RANDOLPH EDDY MS, MMS, PA-C (NPI 1285016394) is an individual medical provider in Kingman, Arizona, licensed in Arizona (6055) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285016394

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. WYATT RANDOLPH EDDYCredential: MS, MMS, PA-C

Location Address3269 STOCKTON HILL RDKingman, AZ 86409-3619

Mailing Address3269 N Stockton Hill RdKingman, AZ 86409-3619 · (928) 757-2101

Phone(928) 757-2101

Sole ProprietorNo

Enumeration DateJune 25, 2015

Last NPPES UpdateDecember 23, 2020

NPPES CertifiedDecember 23, 2020

✔ NPI 1285016394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in AZ · 6055

3269 STOCKTON HILL RD, Kingman, AZ 86409

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Other Identifiers 1

Medicaid033429AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Wyatt Randolph Eddy Ms, Mms, Pa-c 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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

149 services146 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

141 services134 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

20 services19 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

20 services20 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

87.73

Promoting Interoperability

Improvement Activities

Cost

71.28

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers29 claims29 services$75.44 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers24 claims24 services$30.87 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

NANCY SHENOUDA

Pharmacist