Individual provider Active NPI

Emily Kyle, OD

  • Optometrist
  • Otsego, MN
National Provider Identifier
1245073295
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3947 Issued in MN
Practice address
15704 90TH St NE # 100
Otsego, MN 55330-7448
Phone
(763) 241-1090
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3947 MN Primary

Addresses

Primary practice location

15704 90TH St NE # 100
Otsego, MN 55330-7448

Mailing address

15704 90TH St NE # 100
Otsego, MN 55330-7448
Phone (763) 241-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251014002889 MO Practitioner - Optometry 9335636380 Reassigns benefits to 1 organization
I20251115000083 KS Practitioner - Optometry 9335636380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sahni OD LLCGroup PAC ID 5890101786, 2 clinicians
AlphapointeGroup PAC ID 7719929355, 4 clinicians

Practice addresses (Care Compare)

10875 Grandview Dr
Suite 2260
Overland Park, KS 66210-1571
Phone (913) 469-8686

7501 Prospect Ave
Kansas City, MO 64132-2103
Phone (816) 237-2047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3947MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sahni OD LLC Optometrist CurrentSince Sep 8, 2025 Accepting new patients
Bright Eyes Vision Clinic, PA Optometrist CurrentSince Jun 23, 2024 Accepting new patients

Locations

10875 Grandview Dr
Ste 2260
Overland Park, KS 66210
Phone (816) 237-2020

15704 90th St NE
#100
Otsego, MN 55330
Phone (763) 241-1090

Interoperability endpoints

  • Direct secure messaging: emily.kyle.1@32152.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1245073295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15704 90TH ST NE # 100",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553307448",
            "telephone_number": "763-241-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15704 90TH ST NE # 100",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553307448",
            "telephone_number": "763-241-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Otsego, MN

Sources for this page

Verify at the official NPI Registry.