Active NPI
Kyle I. Pirtle, P.A.-C.
- Surgical Physician Assistant
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA10002029
- Practice address
- 200 NE Mother Joseph PL
Suite 110
Vancouver, WA 98664-3299 - Phone
- (360) 254-6161
- Fax
- (360) 449-1146
- NPI assigned
- Jun 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA10002029 | WA | Primary |
Addresses
Primary practice location
200 NE Mother Joseph PL
Suite 110
Vancouver, WA 98664-3299
Mailing address
200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3299
Phone (360) 254-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8355182 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 N Ctr Court St
110 Rebound Sports Medicine
Portland, OR 97227-2104
Phone (503) 732-6863
200 NE Mother Joseph PL
Vancouver, WA 98664-3296
Phone (360) 254-6161
200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161
200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3295
2121 NE 139TH St
300 Rebound
Vancouver, WA 98686-2316
Phone (360) 254-6161
2211 NE 139TH St
Legacy Salmon Creek Medical Center
Vancouver, WA 98686-2742
Phone (360) 487-1000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2029 | WA | MD | Doula |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Surgical Specialists, P.C. | Current | Accepting new patients | |
| Northwest Surgical Specialists PC | Current | Accepting new patients | |
| J and D Physical Therapy Services | Past | Accepting new patients |
Locations
1 N Center Court St
Ste 110
Portland, OR 97227
Phone (503) 732-6863
1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863
200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990
2121 NE 139th St
Ste 300
Vancouver, WA 98686
200 NE Mother Joseph Pl
Ste 305
Vancouver, WA 98664
200 NE Mother Joseph Pl
Ste 110
Vancouver, WA 98664
Phone (360) 256-8584
400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000
200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145
Interoperability endpoints
- kpirtle21911@reboundmd.gardenplot.direct-ci.com
- kyle.pirtlepac.p1@direct.reboundmd.nextgenshare.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.
-
dba Rebound Orthopedics & Neurosurgical Specialists
- Orthopaedic Surgery Physician
- Portland, OR
- NPI 1730118803
WA
-
dba Rebound Physical Therapy Salmon Creek
- Durable Medical Equipment & Medical Supplies
- Vancouver, WA
- NPI 1821510306
-
dba Rebound Orthopedic Physical Therapy
- Physical Therapy Clinic/Center
- Portland, OR
- NPI 1134299951
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Legacy Salmon Creek Providers
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
Hospital
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1275578742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NE MOTHER JOSEPH PL",
"address_2": "SUITE 210",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986643299",
"telephone_number": "360-254-6161",
"fax_number": "360-449-1139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 NE MOTHER JOSEPH PL",
"address_2": "SUITE 110",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986643299",
"telephone_number": "360-254-6161",
"fax_number": "360-449-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIRTLE",
"first_name": "KYLE",
"middle_name": "I.",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-18",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA10002029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8355182",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.