Individual provider Active NPI

Kyle C Moylan, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1124052808
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
2001027314 Issued in MO
Practice address
4901 Forest Park Ave
Div Im Palliative Med, Ste 241
Saint Louis, MO 63108-1495
Phone
(314) 747-5361
Fax
(314) 747-5357
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2001027314 MO
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 2001027314 MO Primary

Addresses

Primary practice location

4901 Forest Park Ave
Div Im Palliative Med, Ste 241
Saint Louis, MO 63108-1495

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 747-5361

Other identifiers 1

IdentifierTypeStateIssuer
209080407MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000297 MO Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Geriatric Medicine 2365455763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Geriatric Medicine, Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4901 Forest Park Ave
Suite 241
Saint Louis, MO 63108-1453
Phone (314) 362-5060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001027314MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 1, 2025 Accepting new patients
Washington University CurrentSince Jul 1, 2025 Accepting new patients
Seasons Hospice & Palliative Care of Missouri, LLC PastSince Aug 1, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Washington University Past Accepting new patients
Nice Nephrology, LLC Past Accepting new patients

Locations

1011 Bowles Ave
Fenton, MO 63026
Phone (314) 843-5800

1011 Bowles Ave
Ste 450
Fenton, MO 63026
Phone (314) 467-1500

3005 N Ballas Rd
Ste 400
Saint Louis, MO 63131
Phone (314) 996-7520

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

1234 S Kingshighway Blvd
Ste 1100
Saint Louis, MO 63110

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

660 S Euclid Ave
#8015
Saint Louis, MO 63110
Phone (314) 286-1018

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

4901 Forest Park Ave
Ste 241
Saint Louis, MO 63108
Phone (314) 747-5361

Interoperability endpoints

  • Direct secure messaging: kyle.moylan.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1124052808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-747-5361",
            "fax_number": "314-747-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE",
            "address_2": "DIV IM PALLIATIVE MED, STE 241",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081495",
            "telephone_number": "314-747-5361",
            "fax_number": "314-747-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "KYLE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-07-15",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2001027314",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MO",
            "license": "2001027314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209080407",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4901 Forest Park Ave",
            "address_2": "Div IM Palliative Med, Ste 241",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631081495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.