Individual provider Active NPI

Kyle Wang, CAA

  • Anesthesiologist Assistant
  • Indianapolis, IN
National Provider Identifier
1619567468
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000070A Issued in IN
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 944-5000
NPI assigned
Jan 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000070A IN Primary

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210128002400 IN Practitioner - Anesthesiology Assistant 5890109045 Reassigns benefits to 1 organization
I20240215001094 TX Practitioner - Anesthesiology Assistant 5890109045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Anesthesiology Group PLLCGroup PAC ID 0547256497, 430 clinicians

Practice addresses (Care Compare)

919 E 32ND St
Austin, TX 78705-2703
Phone (512) 343-2466

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Anesthesiology Associates, LLC CurrentSince Feb 1, 2021 Accepting new patients
Austin Anesthesiology Group PLLC CurrentSince Jan 6, 2024 Accepting new patients
Austin Anesthesiology Group, PLLC Anesthesiologist Assistant CurrentSince Jan 6, 2024 Accepting new patients

Locations

1130 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-0076

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

4307 James Casey St
Austin, TX 78745
Phone (512) 416-6005

1111 W 34th St
Austin, TX 78705
Phone (512) 343-2466

12200 Renfert Way
Ste G-2
Austin, TX 78758
Phone (512) 901-8340

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1201 W Louis Henna Blvd
Austin, TX 78681
Phone (512) 248-7000

12201 Renfert Way
Ste 120
Austin, TX 78758
Phone (512) 454-6753

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

16030 Park Valley Dr
Ste 100
Round Rock, TX 78681
Phone (512) 246-8777

1891 Medical Pkwy
San Marcos, TX 78666
Phone (512) 754-7999

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 3

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1619567468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KYLE",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000070A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.