NPIMap

Individual provider Active NPI

Kyle N Burditt, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1447312434
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
7115 Blanco Rd Ste 101
San Antonio, TX 78216-5045
Phone
(210) 338-8800
Fax
(210) 338-8825
NPI assigned
Dec 15, 2006
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

7115 Blanco Rd Ste 101
San Antonio, TX 78216-5045

Mailing address

7115 Blanco Rd Ste 101
San Antonio, TX 78216-5045
Phone (210) 338-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170724000862 TX Practitioner - Physician Assistant 4981974094 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rise Up Rehab, LLCGroup PAC ID 3274861497, 118 clinicians
Medical Office ForceGroup PAC ID 9335481951, 58 clinicians

Practice addresses (Care Compare)

16400 Blanco Rd
San Antonio, TX 78232-1902
Phone (210) 572-4954

5915 Silver Springs Dr
BLDG 3a
El Paso, TX 79912-4126
Phone (706) 296-8632

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
62.87 of 100Reported as individual
Quality
53.34
Promoting interoperability
83
Improvement activities
40
Cost
11.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office Force CurrentSince Jan 1, 2026 Accepting new patients
Modern MD PLLC PastSince Dec 4, 2020 Accepting new patients

Locations

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

5915 Silver Springs Dr
Bldg 3A
El Paso, TX 79912
Phone (706) 296-8632

Interoperability endpoints

  • Direct secure messaging: kyle.burditt.1@25919.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1447312434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 BLANCO RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165045",
            "telephone_number": "210-338-8800",
            "fax_number": "210-338-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 BLANCO RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165045",
            "telephone_number": "210-338-8800",
            "fax_number": "210-338-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDITT",
        "first_name": "KYLE",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.