NPIMap

Individual provider Active NPI

Kyle J Ericson, MD

  • Urology Physician
  • Westlake, OH
National Provider Identifier
1174933048
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35.142520 Issued in OH
Practice address
29000 Center Ridge Rd Ste 400
Westlake, OH 44145-5219
Phone
(440) 835-8000
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 57.026312 OH
Student in an Organized Health Care Education/Training Program 390200000X IL
Urology Physician 208800000X 35.142520 OH Primary

Addresses

Primary practice location

29000 Center Ridge Rd Ste 400
Westlake, OH 44145-5219

Mailing address

2350 Charney Rd
University Heights, OH 44118-3720
Phone (216) 213-2169

Other identifiers 1

IdentifierTypeStateIssuer
0454660MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810003267 OH Practitioner - Urology 9830490820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

158 W Main Rd
Conneaut, OH 44030-2039

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

960 Clague Rd
Westlake, OH 44145-1586

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041
  • University Hospitals Samaritan Medical Center Hospital, Ashland, OH, CCN 360002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection25
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Aug 1, 2021 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2021 Accepting new patients
Fisher-Titus Medical Care LLC CurrentSince Mar 1, 2022 Accepting new patients
Fisher-Titus Medical Center Current Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

29000 Center Ridge Rd
Ste 400
Westlake, OH 44145
Phone (440) 835-8000

Interoperability endpoints

  • Direct secure messaging: kericson36253@ehrdirect.uhhospitals.org

Organizations & group practices 7

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 8

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": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1174933048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 CHARNEY RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183720",
            "telephone_number": "216-213-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 CENTER RIDGE RD STE 400",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455219",
            "telephone_number": "440-835-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "KYLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "57.026312",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.142520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0454660",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.