Kyle Short

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH17305 Issued in FL

Practice address

2500 Quantum Lakes Dr Ste 105
Boynton Beach, FL 33426-8308

Phone

(561) 770-1780

Fax

(833) 562-8893

NPI assigned

Mar 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Senior Living Memory Health IncGroup PAC ID 7517480577, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Senior Living Memory Health, Inc.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1851847834
  Medicare reassignment Care Compare group NPD
• Mtca Psychological Services P.a.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1740552322
  Medicare reassignment NPD
• Harm Reduction Center LLC

  • Psychiatry Physician
  • North Palm Beach, FL
  • NPI 1346735107
  NPD
• Restorative Therapy for Wellness

  • Clinical Social Worker
  • Boynton Beach, FL
  • NPI 1992370910
  NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1073199048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 QUANTUM LAKES DR STE 105",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268308",
            "telephone_number": "561-770-1780",
            "fax_number": "833-562-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 QUANTUM LAKES DR STE 105",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268308",
            "telephone_number": "561-770-1780",
            "fax_number": "833-562-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH17305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ian Shiman, M.D.
• Michael David Ship, PTA
• Jonathan Shochat, LPO
• Morgan Shope, LMHC
• Laura Ann Shopp
• Marina Shraga, D.D.S
• Shree Hari PSM Inc
• Michael Bryan Shulman, CSA
• Rooptaz Sibia, M.D.
• Sirtaz Singh Sibia, D.O.

• Mental Health Counselor in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.