Individual provider Active NPI

Kyle Harden, PA

  • Medical Physician Assistant
  • Riverview, FL
National Provider Identifier
1184239949
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
13127 Vail Ridge Dr
Riverview, FL 33579-7196
Phone
(813) 661-6199
NPI assigned
Sep 9, 2020
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary
Emergency Medicine Physician 207P00000X 9113509 FL

Addresses

Primary practice location

13127 Vail Ridge Dr
Riverview, FL 33579-7196

Mailing address

1085 Lake Irene Rd
Casselberry, FL 32707-2547
Phone (832) 335-2405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201030000457 FL Practitioner - Physician Assistant 3274943352 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Central Florida LLPGroup PAC ID 1850296567, 132 clinicians

Practice addresses (Care Compare)

380 Rinehart Rd
Lake Mary, FL 32746-2551
Phone (407) 841-5111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9113509FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Central Florida LLP Emergency Medicine CurrentSince Mar 1, 2026 Accepting new patients

Locations

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

575 W State Road 434
Longwood, FL 32750
Phone (321) 841-4514

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, 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": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1184239949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 LAKE IRENE RD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072547",
            "telephone_number": "832-335-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13127 VAIL RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797196",
            "telephone_number": "813-661-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "KYLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "9113509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.