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TYLER PEMBERTON PMHNP
NPI 1639902679
Psychiatry & Neurology - Psychiatry in Mesa, AZ

Active since August 23, 2024PECOS Enrolled
334 W 10TH PL STE 100, MESA, AZ 85201(602) 258-6797(602) 254-2636 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tyler Pemberton Pmhnp NPPES

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

TYLER PEMBERTON PMHNP (NPI 1639902679) is an individual psychiatry provider in Mesa, Arizona, licensed in Arizona (313307) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639902679
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameTYLER PEMBERTONCredential: PMHNP
Location Address334 W 10TH PL STE 100Mesa, AZ 85201-3499
Mailing Address5226 S DrexelMesa, AZ 85212-8511 · (602) 258-6797
Phone(602) 258-6797
Fax(602) 254-2636
Sole ProprietorYes
Enumeration DateAugust 23, 2024
Last NPPES UpdateJuly 29, 2025
NPPES CertifiedJuly 29, 2025
✔ NPI 1639902679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in AZ · 313307
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
334 W 10TH PL STE 100, Mesa, AZ 85201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler Pemberton Pmhnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Tyler Pemberton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Valle Del Sol, Inc.
Same address
Community/Behavioral Health
334 W 10TH PL STE 100
Mesa, AZ 85201
  • Reassigned Medicare billing, Arizona enrollment
  • 75 clinicians in this Medicare group
NPI 1356522684 (602) 258-6797

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 85201 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
$168.60 typical visit price
range $55.44 – $168.60
Typical copayment $42.15 (range $13.86 – $42.15)
Most-billed visit code 99205
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 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VALLE DEL SOL, INC.
Community/Behavioral Health
334 W 10TH PL STE 100
MESA, AZ 85201
Maricopa County (602) 258-6797
JULIE ANN GODEL MS LISAC
Counselor (Addiction (Substance Use Disorder))
334 W 10TH PL STE 100
MESA, AZ 85201
Maricopa County (602) 248-8119
MONICA DIAZ REGISTERED DIETICIAN
Dietitian, Registered
334 W 10TH PL STE 100
MESA, AZ 85201
Maricopa County (602) 258-6797
HELY ESAA PA
Physician Assistant
334 W 10TH PL STE 100
MESA, AZ 85201
Maricopa County (407) 723-9787
VALLE DEL SOL, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
334 W 10TH PL STE 100
MESA, AZ 85201
Maricopa County (602) 258-6797

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 Tyler Pemberton's NPI number?

The NPI number for Tyler Pemberton is 1639902679. It was assigned to this individual provider in the NPPES registry on August 23, 2024.

Where is Tyler Pemberton located?

Tyler Pemberton practices at 334 W 10th Pl Ste 100, Mesa, AZ 85201. The listed phone number is (602) 258-6797.

What is Tyler Pemberton's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Tyler Pemberton enrolled in Medicare?

Yes. Tyler Pemberton is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tyler Pemberton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Pemberton reassigns Medicare benefits to Valle Del Sol, Inc. (Mesa, AZ). 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 Tyler Pemberton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tyler Pemberton accept?

Health plans from Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. list Tyler Pemberton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tyler Pemberton was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.