Individual provider Active NPI

Kyle Erick Kilts, LCSW-R

  • Clinical Social Worker
  • Latham, NY
National Provider Identifier
1063849974
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
15 Cornell Rd
Latham, NY 12110-1491
Phone
(518) 510-3100
NPI assigned
Oct 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NY Primary

Addresses

Primary practice location

15 Cornell Rd
Latham, NY 12110-1491

Mailing address

15 Cornell Rd
Latham, NY 12110-1491
Phone (518) 510-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628002753 NY Practitioner - Clinical Social Worker 7012263346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Clinical CurrentSince May 16, 2018 Accepting new patients

Locations

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

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": "1381276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1063849974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CORNELL RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101491",
            "telephone_number": "518-510-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORNELL RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101491",
            "telephone_number": "518-510-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILTS",
        "first_name": "KYLE",
        "middle_name": "ERICK",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-09",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.