Individual provider Active NPI

Kyle Erkkila, PA-C

  • Physician Assistant
  • South Lake Tahoe, CA
National Provider Identifier
1679716914
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21931 Issued in CA
Practice address
2170B South Ave
South Lake Tahoe, CA 96150-7026
Phone
(530) 541-3100
Fax
(530) 541-3016
NPI assigned
Apr 16, 2009
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1296 NV
Physician Assistant 363A00000X PA21931 CA Primary

Addresses

Primary practice location

2170B South Ave
South Lake Tahoe, CA 96150-7026

Mailing address

2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111209000403 NV Practitioner - Physician Assistant 3971782939 Reassigns benefits to 2 organizations
I20111212000902 CA Practitioner - Physician Assistant 3971782939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

155 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8900

165 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8950

2074 Lake Tahoe Blvd
Suite 4
South Lake Tahoe, CA 96150-6408
Phone (530) 543-5554

2170 B S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 539-6620

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA21931CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Tahoe Orthopaedic Institute a Watson-Swanson Professional Corp CurrentSince Oct 27, 2011 Accepting new patients

Locations

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5659

1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100

935 Mica Dr
Ste 13
Carson City, NV 89705
Phone (775) 783-3065

212 Elks Point Rd
Unit 201
Zephyr Cove, NV 89448
Phone (775) 588-9188

Interoperability endpoints

  • Direct secure messaging: kerkkila87720@direct.renown.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1679716914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170B SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3100",
            "fax_number": "530-541-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERKKILA",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1296",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.