Individual provider Active NPI

Kyle Ann Sloan, P.A.-C.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1295760486
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C02954 Issued in MD
Practice address
4940 Eastern Ave
Baltimore, MD 21224-2735
Phone
(410) 550-0350
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C02954 MD Primary

Addresses

Primary practice location

4940 Eastern Ave
Baltimore, MD 21224-2735

Mailing address

6038 River Birch Court
Hanover, MD 21076
Phone (443) 610-3794

Other names 1

  • Miss Kyle Ann Rutkowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050110000499 MD Practitioner - Physician Assistant 7911955695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

6701 N Charles St
Towson, MD 21204-6808
Phone (443) 849-2000

900 Caton Ave
Baltimore, MD 21229-5201
Phone (410) 368-6000

Hospital & facility affiliations

  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Nov 1, 2023 Accepting new patients
Cep America LLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

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.

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1295760486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6038 RIVER BIRCH COURT",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "21076",
            "telephone_number": "443-610-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "KYLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "RUTKOWSKI",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "P.A.-C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.