Individual provider Active NPI

Kyle R. Eberlin, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Boston, MA
National Provider Identifier
1386844165
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
254385 Issued in MA
Practice address
55 Fruit St # St-435
Massachusetts General Hospital
Boston, MA 02114-2621
Phone
(617) 726-8554
NPI assigned
Jul 20, 2007
Last updated
Jul 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 233003 MA
Plastic and Reconstructive Surgery Physician 2086S0122X 254385 MA Primary
Surgery of the Hand (Surgery) Physician 2086S0105X 254385 MA

Addresses

Primary practice location

55 Fruit St # St-435
Massachusetts General Hospital
Boston, MA 02114-2621

Mailing address

55 Fruit St # St435
Massachusetts General Hospital
Boston, MA 02114-2621
Phone (617) 726-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000127 MA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Orthopedic SurgeryPractitioner - Hand Surgery 1658539192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Boston University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 1, 2013 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Aug 1, 2013 Accepting new patients

Locations

15 Parkman St
Boston, MA 02114
Phone (617) 726-3023

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#435
Boston, MA 02114
Phone (314) 304-7155

Interoperability endpoints

  • Direct secure messaging: eberlin.kyle.mgh@direct.partners.masshiway.net

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 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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1386844165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # ST435",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # ST-435",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLIN",
        "first_name": "KYLE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "233003",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "254385",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "MA",
            "license": "254385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.