Individual provider Active NPI

Kyle D Pfaff, DO

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1396208427
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102207115 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 224-5170
Fax
(540) 983-8229
NPI assigned
Apr 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0102207115 VA Primary

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220728001942 VA Practitioner - Internal Medicine 4880921907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 443-3311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102207115VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Aug 15, 2023 Accepting new patients
Carilion Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Carilion Medical Center CurrentSince Jul 1, 2022 Accepting new patients

Locations

1300 E Marshall St
Richmond, VA 23298
Phone (804) 828-3144

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

3 Riverside Cir
Roanoke, VA 24016

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

Interoperability endpoints

  • Direct secure messaging: kpfaff113034@direct.carilionclinic.org

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 2

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": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396208427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5170",
            "fax_number": "540-983-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAFF",
        "first_name": "KYLE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102207115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.