Active NPI
Kyle Leland Horner, M.D.
- Dermatology Physician
- Lebanon, OR
National Provider Identifier
1528124195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD153145
- Practice address
- 2500 S. Main Road
Lebanon, OR 97355 - Phone
- (541) 258-7546
- Fax
- (541) 570-1744
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD153145 | OR | Primary |
Addresses
Primary practice location
2500 S. Main Road
Lebanon, OR 97355
Mailing address
2500 S. Main Road
Lebanon, OR 97355
Phone (541) 258-7546
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500633817 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Washington University School of Medicine, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
2222 NW Lovejoy St
Suite 422
Portland, OR 97210-5102
Phone (503) 227-7117
2500 S Main Rd
Lebanon, OR 97355-2336
Phone (541) 258-7546
Hospital & facility affiliations
- Samaritan Lebanon Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 639 |
| Removal of skin cancer | 112 |
| Removal or shaving of skin growth | 197 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epiphany Dermatology of Oregon, LLC | Dermatology | Current | Accepting new patients |
| Grace Dermatology & Micrographic Surgery LLC | Current | Accepting new patients |
Locations
2500 S Main Rd
Lebanon, OR 97355
Phone (206) 465-8046
2222 NW Lovejoy St
Ste 422
Portland, OR 97210
Phone (503) 227-7117
7300 Ranch Road 2222
Bldg 1
Austin, TX 78730
Organizations & group practices 2
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.
-
- Dermatology Physician
- Portland, OR
- NPI 1174697239
-
- Medical Specialty Clinic/Center
- Lebanon, OR
- NPI 1184973828
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Lebanon, OR
- NPI 1689625980
-
- Endocrinology, Diabetes & Metabolism Physician
- Lebanon, OR
- NPI 1518347608
Hospital
-
- Substance Abuse Rehabilitation Facility
- Lebanon, OR
- NPI 1669000865
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1528124195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 S. MAIN ROAD",
"city": "LEBANON",
"state": "OR",
"postal_code": "97355",
"telephone_number": "541-258-7546",
"fax_number": "541-570-1744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 S. MAIN ROAD",
"city": "LEBANON",
"state": "OR",
"postal_code": "97355",
"telephone_number": "541-258-7546",
"fax_number": "541-570-1744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORNER",
"first_name": "KYLE",
"middle_name": "LELAND",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "MD153145",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500633817",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.