Individual provider Active NPI

Rachel Boudart Kyle, NP

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1194413054
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LP-0010562 Issued in DE
Practice address
3 Firethorn CT
Newark, DE 19711-4900
Phone
(302) 753-8220
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LP-0010562 DE Primary

Addresses

Primary practice location

3 Firethorn CT
Newark, DE 19711-4900

Mailing address

3 Firethorn CT
Newark, DE 19711-4900
Phone (302) 753-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240909001536 DE Practitioner - Nurse Practitioner 3577003227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endovascular Consultants LLCGroup PAC ID 2769751791, 3 clinicians

Practice addresses (Care Compare)

701 N Clayton St
MSB Suite 601
Wilmington, DE 19805-3165
Phone (302) 760-9002

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endovascular Consultants, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

701 N Clayton St
#601
Wilmington, DE 19805
Phone (302) 575-8368

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

Organizations & group practices 1

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1194413054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FIRETHORN CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197114900",
            "telephone_number": "302-753-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FIRETHORN CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197114900",
            "telephone_number": "302-753-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "RACHEL",
        "middle_name": "BOUDART",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LP-0010562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.