Individual provider Active NPI

Kyle Patrick Lavery, M.D.

  • Orthopaedic Surgery Physician
  • Leominster, MA
National Provider Identifier
1053624148
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
261801 Issued in MA
Practice address
100 Hospital Rd
Leominster, MA 01453-2253
Phone
(978) 466-4220
Fax
(978) 466-4240
NPI assigned
Jul 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 261801 MA Primary

Addresses

Primary practice location

100 Hospital Rd
Leominster, MA 01453-2253

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 1

IdentifierTypeStateIssuer
110103546AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210401001791 CT Practitioner - Orthopedic Surgery 4385951631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

15 Riverside Ave
Bristol, CT 06010-6312
Phone (860) 585-3333

Hospital & facility affiliations

  • Bristol Hospital Hospital, Bristol, CT, CCN 070029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi Specialty Group, Inc Orthopaedic Surgery CurrentSince Apr 1, 2021 Accepting new patients

Locations

15 Riverside Ave
Bristol, CT 06010
Phone (860) 516-7593

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

Interoperability endpoints

  • Direct secure messaging: kyle.lavery@bhmg.eclinicaldirectplus.com

Organizations & group practices 1

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

Hospital & facility affiliations 1

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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1053624148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532253",
            "telephone_number": "978-466-4220",
            "fax_number": "978-466-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERY",
        "first_name": "KYLE",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "261801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110103546A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.