Individual provider Active NPI

Mary Sue Kyle

  • Audiologist
  • Rockledge, FL
National Provider Identifier
1063685063
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY244 Issued in FL
Practice address
1099 Florida Ave S
Rockledge, FL 32955-2138
Phone
(321) 632-6900
Fax
(321) 639-7222
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY244 FL Primary

Addresses

Primary practice location

1099 Florida Ave S
Rockledge, FL 32955-2138

Mailing address

1099 Florida Ave S
Rockledge, FL 32955-2138
Phone (321) 632-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081022000395 FL Practitioner - Qualified Audiologist 9032277975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Ear Nose and Throat Center PAGroup PAC ID 6204904634, 7 clinicians

Practice addresses (Care Compare)

1099 Florida S Ave
Rockledge, FL 32955-2138
Phone (321) 632-6900

Merit-based Incentive Payment System (MIPS)

Final score
92.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Ear Nose & Throat Center PA CurrentSince Oct 1, 2008 Accepting new patients

Locations

1099 Florida Ave S
Rockledge, FL 32955
Phone (321) 632-6900

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.133

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.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1063685063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552138",
            "telephone_number": "321-632-6900",
            "fax_number": "321-639-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552138",
            "telephone_number": "321-632-6900",
            "fax_number": "321-639-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "MARY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.