Individual provider Active NPI

Kyle Alfred Forte

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1467947986
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
95082 Issued in GA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4299
Phone
(215) 612-5161
Fax
(215) 612-4069
NPI assigned
Jun 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 95082 GA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4299

Mailing address

112 Wall St
St Simons Island, GA 31522-5838
Phone (270) 493-2003

Other practice location 1

112 Wall St
St Simons Island, GA 31522-5838
Phone (270) 493-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230814003629 GA Practitioner - Emergency Medicine 4082960521 Reassigns benefits to 2 organizations
I20240918001640 KY Practitioner - Emergency Medicine 4082960521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95082GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 29, 2024 Accepting new patients

Locations

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

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.

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1467947986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WALL ST",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225838",
            "telephone_number": "270-493-2003",
            "fax_number": "215-612-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144299",
            "telephone_number": "215-612-5161",
            "fax_number": "215-612-4069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Wall St",
            "address_purpose": "LOCATION",
            "city": "St Simons Island",
            "state": "GA",
            "postal_code": "315225838",
            "country_code": "US",
            "telephone_number": "270-493-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTE",
        "first_name": "KYLE",
        "middle_name": "ALFRED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "95082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.