Individual provider Active NPI

Kyle William Kraft, PA-C

  • Medical Physician Assistant
  • Evansville, IN
National Provider Identifier
1649793522
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10002244A Issued in IN
Practice address
901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521
Phone
(812) 473-2642
NPI assigned
Jul 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10002244A IN
Medical Physician Assistant 363AM0700X 10002244A IN Primary

Addresses

Primary practice location

901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521

Mailing address

901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521

Other practice location 1

520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kyle.kraft.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170921000088 IN Practitioner - Physician Assistant 2769756394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Evansville, IN 47714-0541

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

901 Saint Marys Dr
Suite 300
Evansville, IN 47714-0521
Phone (812) 473-2642

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kyle.kraft.1@7598.direct.athenahealth.com

Organizations & group practices 1

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 1

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": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1649793522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 300",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 300",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140521",
            "telephone_number": "812-473-2642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Mary St Ste 520",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477101682",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAFT",
        "first_name": "KYLE",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10002244A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002244A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.kraft.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "901 Saint Marys Dr Ste 300",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.