Kyle McIntosh, D.O.

Individual provider Active NPI Family Medicine Physician · Patrick Afb, FL

NPI 1609216050 · NPPES record last updated Apr 29, 2026

Key facts

NPI
1609216050
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
1225 (NE)
Practice address
1381 S Patrick Dr
Patrick Afb, FL 32925-3606
Phone
(321) 494-8989
NPI assigned
Jun 30, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150406002083 NV Order and Referring Only - General Practice
Practitioner - General Practice
5597083469

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1225NEMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1225 NE Yes

Addresses

Primary practice location

1381 S Patrick Dr
Patrick Afb, FL 32925-3606

Mailing address

1381 S Patrick Dr
Patrick Afb, FL 32925-3606
Phone (321) 494-8989

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-3040

Other providers in Patrick Afb, FL

All providers in Patrick Afb, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.