Individual provider Active NPI

Kyle Remington Dennis, PT

  • Physical Therapist
  • Muskogee, OK
National Provider Identifier
1083012652
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4236 Issued in OK
Practice address
536 N Main St
Muskogee, OK 74401-6345
Phone
(918) 683-8555
Fax
(918) 683-8552
NPI assigned
Dec 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4236 OK Primary

Addresses

Primary practice location

536 N Main St
Muskogee, OK 74401-6345

Mailing address

2234-B W Houston Street
Broken Arrow, OK 74012-3519
Phone (918) 259-1888

Other identifiers 1

IdentifierTypeStateIssuer
200567580AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150116000896 OK Practitioner - Physical Therapist in Private Practice 6901120195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Therapy Specialists, LLCGroup PAC ID 1759294689, 16 clinicians

Practice addresses (Care Compare)

2232 B W Houston St
Broken Arrow, OK 74012-3529

2232 W Houston St
Broken Arrow, OK 74012-3529
Phone (918) 259-9522

536 N Main St
Muskogee, OK 74401-6345
Phone (918) 683-8555

Merit-based Incentive Payment System (MIPS)

Final score
13.69 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
45.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4236OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince Dec 13, 2014 Accepting new patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince Dec 13, 2014 Accepting new patients

Locations

2232 W Houston St
Broken Arrow, OK 74012
Phone (918) 259-1888

2234 W Houston St
Ste B
Broken Arrow, OK 74012
Phone (918) 259-1888

536 N Main St
Muskogee, OK 74401
Phone (918) 683-8555

2424 E 21st St
Ste 400
Tulsa, OK 74114
Phone (918) 743-9235

Organizations & group practices 2

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1083012652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234-B W HOUSTON STREET",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123519",
            "telephone_number": "918-259-1888",
            "fax_number": "918-251-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744016345",
            "telephone_number": "918-683-8555",
            "fax_number": "918-683-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "KYLE",
        "middle_name": "REMINGTON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-15",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200567580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.