Kyle Matthew Waisanen, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME162353 Issued in FL

Practice address

2400 Harbor Blvd Ste 8
Port Charlotte, FL 33952-5038

Phone

(941) 766-5070

Fax

(941) 766-5071

NPI assigned

Apr 9, 2018

Last updated

Sep 14, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Urology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mackinac Straits Health System IncGroup PAC ID 1456420876, shared by 7 NPIs, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mackinac Straits Hospital and Health Center Hospital, Saint Ignace, MI, CCN 231306
• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Chippewa County War Memorial Hospital Hospital, Sault Ste Marie, MI, CCN 230239

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Oasis Health Urology, PLLC

  dba Oasis Health Urology

  • Urology Physician
  • Petoskey, MI
  • NPI 1215724745
  Medicare reassignment NPD Authorized official
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Mackinac Straits Health System Inc

  dba Mackinac Straits Hospital and Health Center

  • Critical Access Hospital
  • Saint Ignace, MI
  • NPI 1124283502
  Medicare reassignment NPD
• Mackinac Straits Health System Inc

  dba Mackinac Straits Hospital and Health Center

  • General Practice Physician
  • Saint Ignace, MI
  • NPI 1659536035
  Medicare reassignment NPD
• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  NPD
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  dba LCH- Pediatric Ophthalmology

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD
• Mackinac Straits Health System Inc

  dba Rivertown Medical Clinic

  • Rural Health Clinic/Center
  • Cheboygan, MI
  • NPI 1659868206
  NPD
• Mackinac Straits Health System Inc

  dba St. Ignace Medical Clinic

  • Rural Health Clinic/Center
  • Saint Ignace, MI
  • NPI 1013172493
  NPD (past)
• Mackinac Straits Health System Inc

  • Rural Health Clinic/Center
  • Mackinaw City, MI
  • NPI 1245554914
  NPD (past)

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

• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation
• Mackinac Straits Health System Inc

  dba Mackinac Straits Hospital and Health Center

  • Critical Access Hospital
  • Saint Ignace, MI
  • NPI 1124283502
  Care Compare affiliation
• Mackinac Straits Health System Inc

  dba Rivertown Medical Clinic

  • Rural Health Clinic/Center
  • Cheboygan, MI
  • NPI 1659868206

  Hospital

  Care Compare affiliation
• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation
• Mymichigan Medical Center Sault

  dba Chippewa County War Memorial Hospital, Inc

  • General Acute Care Hospital
  • Sault Sainte Marie, MI
  • NPI 1295756948
  Care Compare affiliation

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1033616909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD STE 8",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-766-5070",
            "fax_number": "941-766-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD STE 8",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-766-5070",
            "fax_number": "941-766-5071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "932 Spring St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702286",
            "country_code": "US",
            "telephone_number": "231-489-8298",
            "fax_number": "231-489-8299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1140 N State St",
            "address_purpose": "LOCATION",
            "city": "Saint Ignace",
            "state": "MI",
            "postal_code": "497811048",
            "country_code": "US",
            "telephone_number": "906-643-8585",
            "fax_number": "906-643-6188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18669 Tamiami Trl Ste B",
            "address_purpose": "LOCATION",
            "city": "North Port",
            "state": "FL",
            "postal_code": "342877388",
            "country_code": "US",
            "telephone_number": "941-423-5040",
            "fax_number": "941-423-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAISANEN",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME162353",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301513351",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118384100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4301513351",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Galina Victorovna Vos
• Kristen Vulgamore, APRN
• Lisa Marie Vullo, LCSW
• Svitlana O Wagner, MSN, FNP
• Sara Elizabeth Wainwright, PA-C
• Dylan Waite
• Latoy Renae Waite, PHARM.D.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3349)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0721)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6937)

• Urology Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.