Kyle Franklin Brock, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

62398 Issued in WI

Practice address

9200 W Wisconsin Ave
Department of Radiology
Milwaukee, WI 53226-3522

Phone

(414) 805-3700

Fax

(414) 805-3777

NPI assigned

May 18, 2009

Last updated

Jul 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, CO2 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

Specialty

Diagnostic Radiology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology IncGroup PAC ID 5890695464, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Goshen Hospital Hospital, Goshen, IN, CCN 150026
• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Radiology, Inc

  • Diagnostic Radiology Physician
  • Mishawaka, IN
  • NPI 1578557815

  CO

  Medicare reassignment Care Compare group NPD
• Beacon Health, LLC

  dba Beacon Imaging Mishawaka

  • Diagnostic Radiology Physician
  • Mishawaka, IN
  • NPI 1912796699
  NPD
• Beacon Health, LLC

  dba Beacon Imaging

  • Diagnostic Radiology Physician
  • Goshen, IN
  • NPI 1952982217
  NPD
• Cher, LLC

  dba Health Images Quail Crossing

  • Diagnostic Radiology Physician
  • Westminster, CO
  • NPI 1598514671
  NPD (past)
• Memorial Lighthouse Imaging LLC

  • Diagnostic Ultrasound Physician
  • South Bend, IN
  • NPI 1730225848

  Diagnostic Radiology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Hospital of Bremen, Inc

  • Critical Access Hospital
  • Bremen, IN
  • NPI 1568417004
  Care Compare affiliation
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Memorial Epworth Center

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Beacon Granger Hospital, A Memorial Hospital Extension

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation
• Three Rivers Health System, Inc

  dba Three Rivers Health

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1568697753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3700",
            "fax_number": "414-805-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3700",
            "fax_number": "414-805-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "KYLE",
        "middle_name": "FRANKLIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2010019014",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "62398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568697753",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broadstep-Wisconsin, Inc.
• Broadstep-Wisconsin, Inc. (Lisbon Home)
• Broadstep-Wisconsin, Inc.
• Broadstep-Wisconsin, Inc.
• Erin Broadway, FNP
• Samantha Brock, MSW, APSW
• Donna Marie Brocker, OTR
• Staley A Brod, M.D.
• Adela Brodek, DDS
• Clare Broderick

• Diagnostic Radiology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.

Verify at the official NPI Registry.