Individual provider Active NPI

Michael Daniel Kyle, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Medford, OR
National Provider Identifier
1356584106
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD171633 Issued in OR
Practice address
1032 E Jackson St
Medford, OR 97504-7027
Phone
(541) 770-4559
NPI assigned
Apr 9, 2009
Last updated
Aug 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 41862 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A115581 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD171633 OR Primary

Addresses

Primary practice location

1032 E Jackson St
Medford, OR 97504-7027

Mailing address

PO Box 1000
Medford, OR 97501-0071
Phone (541) 770-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150709002505 OR Practitioner - Pathology 2567689870 Reassigns benefits to 1 organization
I20250128004627 CA Practitioner - Pathology 2567689870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loma Linda University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Pathology Laboratory LLCGroup PAC ID 4587827985, 12 clinicians
Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

1032 E Jackson St
Medford, OR 97504-7027
Phone (541) 770-4559

280 Maple St
Ashland, OR 97520-1552
Phone (541) 201-4030

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-4191

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A115581CAMDAnatomic Pathology & Clinical Pathology Physician
41862IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Dec 17, 2024 Accepting new patients
Vista Pathology Laboratory, LLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 11, 2019 Accepting new patients
Vista Pathology Laboratory, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients

Locations

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

1032 E Jackson St
Medford, OR 97504
Phone (541) 770-4559

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1356584106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010071",
            "telephone_number": "541-770-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047027",
            "telephone_number": "541-770-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "41862",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A115581",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD171633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.