Kyle Fitzgerald Nelson, MD
Individual provider Active NPI Cardiovascular Disease Physician · Wynnewood, PA
NPI 1306307335 · NPPES record last updated Aug 7, 2025
Key facts
- NPI
- 1306307335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- MD487714 (PA)
- Practice address
- 100 E Lancaster Ave
Lankenau Heart Pavilion, Mezzanine Level
Wynnewood, PA 19096-3435 - Phone
- (484) 476-1000
- NPI assigned
- Mar 31, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Rutgers, Robert Woood Johnson Medical School, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Main Line Healthcare
Practice addresses (Care Compare)
100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-4327
Hospital & facility affiliations
- Main Line Hospital Lankenau
- Paoli Hospital
- Bryn Mawr Hospital
- Riddle Memorial Hospital
- Hospital of Univ of Pennsylvania
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250701001323 | PA | Practitioner - Cardiovascular Disease (Cardiology) |
0941531248 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD487714 | PA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Healthcare | Current |
Accepting new patients |
Locations
830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200
3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530
100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD487714 | PA | Yes |
Addresses
Primary practice location
100 E Lancaster Ave
Lankenau Heart Pavilion, Mezzanine Level
Wynnewood, PA 19096-3435
Mailing address
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1632
Other practice location 1
1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-6500
Other providers in Wynnewood, PA
- Zina Naughton
- Judith Tan Navarro
- Monisha Chakraborty Nayar-Akhtar
- Gerd Ralph Naydock
- Charles Douglas Neff
- Jacqueline Eve Nemec
- Jacqueline Neminski
- Nephrology Associates Inc
- Neurology Associates of the Main Line
- Stephanie Kline Newberg
All providers in Wynnewood, PA · Cardiovascular Disease Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.