Individual provider Active NPI

Kyle McCarthy, FNP

  • Primary Care Nurse Practitioner
  • Canton, IL
National Provider Identifier
1346693504
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209014506 Issued in IL
Practice address
180 S Main St
Canton, IL 61520-2608
Phone
(309) 647-0201
Fax
(309) 649-6880
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209014506 IL Primary

Addresses

Primary practice location

180 S Main St
Canton, IL 61520-2608

Mailing address

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kyle.mccarthy@gmgil.eclinicaldirectplus.com Health Information Exchange (HIE) Graham Hospital Association

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160920000468 IL Practitioner - Nurse Practitioner 3375830318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

61 E Side SQ
Canton, IL 61520-2603
Phone (309) 649-1572

Hospital & facility affiliations

  • Graham Hospital Association Hospital, Canton, IL, CCN 140001
  • Graham Hospital Association Hospital, Canton, IL, CCN 141356
  • Mason District Hospital Hospital, Havana, IL, CCN 141313

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
62.57
Promoting interoperability
100
Improvement activities
40
Cost
77.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209014506ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association CurrentSince Aug 2, 2016 Accepting new patients
Graham Hospital Association CurrentSince Aug 2, 2016 Accepting new patients
Graham Hospital Association Current Accepting new patients
Graham Hospital Association Past Accepting new patients

Locations

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

408 S Main St
Lewistown, IL 61542
Phone (309) 547-9700

Interoperability endpoints

  • Direct secure messaging: kyle.mccarthy@gmgil.eclinicaldirectplus.com

Organizations & group practices 4

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 3

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1346693504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-647-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KYLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209014506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.mccarthy@gmgil.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Graham Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "180 S Main St",
            "city": "Canton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615202608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.