Individual provider Active NPI

Kyle Patrick Pfefferle

  • Emergency Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1215356340
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
300658 Issued in LA
Practice address
3113 Grand Way Ave
Baton Rouge, LA 70810-0422
Phone
(225) 328-0697
NPI assigned
Apr 16, 2014
Last updated
May 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 300658 LA Primary

Addresses

Primary practice location

3113 Grand Way Ave
Baton Rouge, LA 70810-0422

Mailing address

3113 Grand Way Ave
Baton Rouge, LA 70810-0422
Phone (225) 328-0697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160726001896 LA Practitioner - Emergency Medicine 4183913502 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
91.13
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Davis Emergency Group LLC Emergency Medicine CurrentSince Jun 11, 2016 Accepting new patients
Vermilion Emergency Group LLC Emergency Medicine CurrentSince Jun 11, 2016 Accepting new patients
Red Stick Emergency Group LLC Emergency Medicine CurrentSince Nov 4, 2020 Accepting new patients
Thibodaux Emergency Physicians Group LLC Emergency Medicine CurrentSince Jul 17, 2017 Accepting new patients
Baton Rouge General Medical Center Past Accepting new patients

Locations

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

1634 Elton Rd
Jennings, LA 70546
Phone (337) 616-7000

1310 W 7th St
Kaplan, LA 70548
Phone (318) 643-8300

14105 Highway 73
Ste 100
Prairieville, LA 70769
Phone (225) 402-2600

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1215356340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 GRAND WAY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708100422",
            "telephone_number": "225-328-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 GRAND WAY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708100422",
            "telephone_number": "225-328-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFERLE",
        "first_name": "KYLE",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "300658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.