Kyle Fistner, DO
Individual provider Active NPI Addiction Medicine (Internal Medicine) Physician · Hardwick, NJ
NPI 1407377013 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1407377013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Internal Medicine) Physician 207RA0401X
- License
- 25MB12608300 (NJ)
- Practice address
- 61 Ward Rd
Hardwick, NJ 07825-9636 - Phone
- (908) 362-6114
- NPI assigned
- Jul 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20241108002480 | PA | Order and Referring Only - Internal Medicine |
1355875659 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB12608300 | NJ | MD | Addiction Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Hill Foundation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician |
207RA0401X | 25MB12608300 | NJ | Yes |
Addresses
Primary practice location
61 Ward Rd
Hardwick, NJ 07825-9636
Mailing address
61 Ward Rd
Hardwick, NJ 07825-9636
Phone (908) 362-6114
Other providers in Hardwick, NJ
- Oscar Coetzee
- Jessica Lynn Custer
- Ali Michelle Durino
- Little Hill Foundation
- Maria Satmary
- Willowglen Academy-New Jersey, Inc.
All providers in Hardwick, NJ · Addiction Medicine (Internal Medicine) Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.