NPIMap

Individual provider Active NPI

Kade Shumway Lyman

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Monticello, UT
National Provider Identifier
1003270059
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
12868441-1205 Issued in UT
Practice address
380 W 100 N
Monticello, UT 84535-7879
Phone
(435) 587-2116
NPI assigned
Apr 6, 2016
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 12868441-1205 UT Primary

Addresses

Primary practice location

380 W 100 N
Monticello, UT 84535-7879

Mailing address

380 W 100 N
Monticello, UT 84535-7879

Other practice location 1

1000 W Carson St
Torrance, CA 90502-2004
Phone (310) 222-2716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831002679 UT Practitioner - Orthopedic Surgery 0749683423 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Utah School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kane County Human Resource Special Service DistrictGroup PAC ID 5092603316, shared by 8 NPIs, 36 clinicians
San Juan County HospitalGroup PAC ID 4486541851, shared by 5 NPIs, 19 clinicians

Practice addresses (Care Compare)

355 N Main St
Kanab, UT 84741-3260
Phone (435) 644-4115

380 W 100
Monticello, UT 84535-0308
Phone (435) 587-2116

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12868441-1205UTMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kane County Human Resource Special Service District Current Accepting new patients
Kane County Human Resource Special Service District CurrentSince Nov 29, 2024 Accepting new patients
San Juan County Hospital CurrentSince Sep 1, 2022 Accepting new patients
Kane County Human Resource Special Service District Current Accepting new patients
Kane County Human Resource Special Service District CurrentSince Nov 29, 2024 Accepting new patients
Blue Mountain Hospital Current Accepting new patients
San Juan County Hospital CurrentSince Sep 1, 2022 Accepting new patients
San Juan County Hospital Current Accepting new patients
San Juan County Hospital CurrentSince Nov 24, 2025 Accepting new patients
San Juan County Hospital Past Accepting new patients

Locations

735 S 200 W
Ste 3
Blanding, UT 84511
Phone (435) 678-2254

802 S 200 W
Blanding, UT 84511
Phone (435) 678-3869

802 S 200 W
Ste A
Blanding, UT 84511
Phone (435) 678-3993

355 N Main St
Kanab, UT 84741
Phone (435) 644-4100

5555 Old Airport Rd
Moab, UT 84532
Phone (435) 419-9210

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16299/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/
  • Direct secure messaging: kade.lyman.1@16299.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1003270059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W 100 N",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "845357879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W 100 N",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "845357879",
            "telephone_number": "435-587-2116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-2716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "KADE",
        "middle_name": "SHUMWAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "12868441-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, UT

Sources for this page

Verify at the official NPI Registry.