NPIMap

Individual provider Active NPI

Kyle William Lacy, M.D.

  • Orthopaedic Surgery Physician
  • Detroit, MI
National Provider Identifier
1568779338
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301097292 Issued in MI
Practice address
4201 St. Antoine
Uhc 6D5.5
Detroit, MI 48201
Phone
(313) 966-8013
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301097292 MI Primary

Addresses

Primary practice location

4201 St. Antoine
Uhc 6D5.5
Detroit, MI 48201

Mailing address

724 York St
Plymouth, MI 48170-1483
Phone (949) 257-6183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720001957 MA Practitioner - Orthopedic Surgery 9830402882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Kentucky College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

331 Gloucester Crossing Rd
Gloucester, MA 01930-2283
Phone (978) 879-4047

Hospital & facility affiliations

  • Beth Israel Lahey Health at Home Home health agency, Beverly, MA, CCN 227495
  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Amedisys Home Health Care Home health agency, Wakefield, MA, CCN 227211
  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Elara Caring Home health agency, Newburyport, MA, CCN 227503
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement51
Knee replacement88
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301097292MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine North Orthopaedic Surgery, Inc. CurrentSince Apr 22, 2019 Accepting new patients
Sports Medicine North Orthopaedic Surgery, Inc CurrentSince Apr 22, 2019 Accepting new patients
Northeast Hospital Corporation Past Accepting new patients

Locations

30 Tozer Rd
Ste 201
Beverly, MA 01915
Phone (978) 712-9081

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

331 Gloucester Crossing Rd
Gloucester, MA 01930
Phone (978) 818-6493

1 Orthopedics Dr
Peabody, MA 01960
Phone (781) 595-4562

1 Orthopedics Dr
Ste 2
Peabody, MA 01960
Phone (978) 818-6493

Interoperability endpoints

  • Direct secure messaging: kyle.lacy.1@7605.direct.athenahealth.com

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1568779338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 YORK ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701483",
            "telephone_number": "949-257-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE",
            "address_2": "UHC 6D5.5",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-966-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "KYLE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301097292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.