Kyle Matthew Rickstad, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA5210 Issued in MA

Practice address

130 North St
Cape Cod Orthopaedics and Sports Medicine, P.C.
Hyannis, MA 02601-3825

Phone

(508) 568-3761

Fax

(508) 775-2352

NPI assigned

Oct 24, 2014

Last updated

Oct 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Gastroenterology Specialists of Southwest Florida PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Naples, FL
  • NPI 1710102207
  Medicare reassignment
• Clearchoicemd Primary Care PLLC

  • Family Medicine Physician
  • Saint Albans, VT
  • NPI 1326582529
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1538564174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "address_2": "CAPE COD ORTHOPAEDICS AND SPORTS MEDICINE, P.C.",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-568-3761",
            "fax_number": "508-775-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "address_2": "CAPE COD ORTHOPAEDICS AND SPORTS MEDICINE, P.C.",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-568-3761",
            "fax_number": "508-775-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKSTAD",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA5210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Peter Rich Jr., DMD
• Richard J Haskell, D.M.D P.C
• Kristen B. Richards
• Rebecca Richardson Gray, M.A.
• Kyle Anthony Richardson
• Nanci Jean Rindfuss
• Catherine Rios-Cisneros, B.S.
• Bridget Rivera, PA-C
• Tracey Roach
• Rob Ritchey DPM Inc

• Surgical Physician Assistant in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Surgical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.