Kylie Jennifer Kofler, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13739 Issued in NC

Practice address

1010 High House Rd Ste 202
Cary, NC 27513-3576

Phone

(919) 388-9103

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

No

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 NC, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Duke University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berman Skin Institute Medical Group IncGroup PAC ID 0042407215, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Berman Skin Institute Medical Group Inc

  • Dermatology Physician
  • Los Altos, CA
  • NPI 1528175528
  Medicare reassignment Care Compare group
• Preston Dermatology & Skin Surgery Center PA

  • Dermatology Physician
  • Cary, NC
  • NPI 1508395468
  Medicare reassignment NPD

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1083486534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 NEWFIELDS PL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277033481",
            "telephone_number": "760-504-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HIGH HOUSE RD STE 202",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133576",
            "telephone_number": "919-388-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFLER",
        "first_name": "KYLIE",
        "middle_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mrinalini Sujala Kodumagulla, M.D.
• Sara Koenig, MD, MBA
• Stephanie Margarete Koenig, LCSW-A
• Erin Koenke, PT, DPT
• Brandon Dale Kofford, DMD
• Kalyani Koganti
• Sushma Kola, DDS
• Kamal Kumar Padmanabhan Kolappa, MD
• Shraddha Patel Kolappa, D.D.S.
• Manasa Kolli

• Physician Assistant in Cary, NC
• Providers in Cary, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.