Individual provider Active NPI

Kyle Sulzer

  • Physician Assistant
  • Somers Point, NJ
National Provider Identifier
1083251011
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00554800 Issued in NJ
Practice address
649 Shore Rd
Somers Point, NJ 08244-2449
Phone
(609) 365-6239
NPI assigned
Dec 10, 2019
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00554800 NJ Primary

Addresses

Primary practice location

649 Shore Rd
Somers Point, NJ 08244-2449

Mailing address

1 E. New York Ave
4TH Floor Admin
Somers Point, NJ 08244
Phone (609) 653-3265

Other identifiers 1

IdentifierTypeStateIssuer
0754536MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200131000742 NJ Practitioner - Physician Assistant 4385070879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shore Specialty ConsultantsGroup PAC ID 1951613652, 42 clinicians

Practice addresses (Care Compare)

1 E New York Ave
4TH Floor SPG Admin
Somers Point, NJ 08244-2300

100 Medical Ctr Way
3Rd Floor
Somers Point, NJ 08244-2300
Phone (609) 653-3585

4 W Roosevelt Blvd
Marmora, NJ 08223-1441
Phone (609) 814-9550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.93 of 100Reported as group
Quality
82.11
Promoting interoperability
100
Improvement activities
40
Cost
68.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00554800NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Physicians Associates PA CurrentSince Dec 22, 2019 Accepting new patients
Bayfront Urgent Care PA PastSince Jun 25, 2023 Accepting new patients

Locations

2 Stone Harbor Blvd
Cape May Court House, NJ 08210
Phone (609) 463-2000

215 N Main St
Cape May Court House, NJ 08210
Phone (609) 463-2273

Interoperability endpoints

  • Direct secure messaging: kyle.sulzer.1@4024.direct.athenahealth.com
  • Direct secure messaging: kyle.sulzer.2@4024.direct.athenahealth.com

Organizations & group practices 3

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

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": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1083251011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E. NEW YORK AVE",
            "address_2": "4TH FLOOR ADMIN",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "08244",
            "telephone_number": "609-653-3265",
            "fax_number": "609-926-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442449",
            "telephone_number": "609-365-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULZER",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-10",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00554800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0754536",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

Verify at the official NPI Registry.