Kyle Anderson, PA
Individual provider Active NPI Physician Assistant · Las Vegas, NV
NPI 1508459231 · NPPES record last updated Feb 6, 2026
Key facts
- NPI
- 1508459231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2376 (NV)
- Practice address
- 9010 W Cheyenne Ave
Las Vegas, NV 89129-8932 - Phone
- (702) 240-8646
- NPI assigned
- Feb 13, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Revere Health PC
Dana Forte D O LTD
Practice addresses (Care Compare)
140 White Sage Ave
Delta, UT 84624-8928
Phone (435) 864-3333
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone (702) 240-8646
Hospital & facility affiliations
- Intermountain Health Delta Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210330000843 | NV | Practitioner - Physician Assistant | 8123435625 | Reassigns benefits to 1 organization |
| I20260226001092 | UT | Practitioner - Physician Assistant | 8123435625 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14267947-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients |
Locations
140 White Sage Ave
Delta, UT 84624
Phone (435) 864-3333
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14267947-1206 | UT | |
| Physician Assistant | 363A00000X | PA2376 | NV | Yes |
Addresses
Primary practice location
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Mailing address
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone (702) 240-8646
Other practice location 1
140 White Sage Ave
Delta, UT 84624-8928
Phone (435) 864-3333
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.fortefamilypractice.com |
Other providers in Las Vegas, NV
- Kesean Mishae Anderson
- Kierra Anderson
- Kimberley Nicole Anderson
- Kristen E Anderson
- Kristine Angel Anderson
- Laritta Devine Anderson
- Latasha Anderson
- Latoya Marie Anderson
- Latriana Anderson
- Laura Beth Anderson
All providers in Las Vegas, NV · Physician Assistant in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.