Individual provider Active NPI

Kyle James Fitzgerald, DO

  • Surgery Physician
  • Kansas City, KS
National Provider Identifier
1679351720
Registry record updated Jun 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
94-12317 Issued in KS
Practice address
3901 Rainbow Blvd # Ms 2005
Kansas City, KS 66160-1886
Phone
(913) 588-6124
Fax
(913) 588-7540
NPI assigned
Sep 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 94-12317 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd # Ms 2005
Kansas City, KS 66160-1886

Mailing address

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250618002313 KS Order and Referring Only - General SurgeryPractitioner - General Surgery 3678084399

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1679351720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 2005",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661601886",
            "telephone_number": "913-588-6124",
            "fax_number": "913-588-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "94-12317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.