Individual provider Active NPI

Kyle Andrew Stewart, MD

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1457557571
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25710 Issued in OK
Practice address
1200 N Phillips Ave
Suite 6100
Oklahoma City, OK 73104-4600
Phone
(405) 271-6827
Fax
(405) 271-4418
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25710 OK Primary

Addresses

Primary practice location

1200 N Phillips Ave
Suite 6100
Oklahoma City, OK 73104-4600

Mailing address

1200 N Phillips Ave
Oucpb 12400
Oklahoma City, OK 73104-4600
Phone (405) 271-4407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100907001122 OK Practitioner - Pediatric Medicine 5991829335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25710OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. CurrentSince Feb 25, 2013 Accepting new patients
Variety Care, Inc CurrentSince Feb 25, 2013 Accepting new patients
Variety Care, Inc. Current Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

721 W Britton Rd
Oklahoma City, OK 73114
Phone (405) 607-5757

Interoperability endpoints

  • Direct secure messaging: kstewart376779@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1457557571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N PHILLIPS AVE",
            "address_2": "OUCPB 12400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044600",
            "telephone_number": "405-271-4407",
            "fax_number": "405-271-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N PHILLIPS AVE",
            "address_2": "SUITE 6100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044600",
            "telephone_number": "405-271-6827",
            "fax_number": "405-271-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "25710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.