Kyle Evan Hollingsworth, PA
Individual provider Active NPI Physician Assistant · Oklahoma City, OK
NPI 1700826419 · NPPES record last updated Jul 10, 2019
Key facts
- NPI
- 1700826419
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1341 (OK)
- Practice address
- 8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475 - Phone
- (405) 632-4468
- Fax
- (405) 632-0436
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Orthopaedic Specialists, PLLC
Immediate Care of Oklahoma LLC
Practice addresses (Care Compare)
1805 Commons Cir
Suite 100C
Yukon, OK 73099-9519
Phone (405) 265-0165
2506 N Harrison St
Shawnee, OK 74804-3131
Phone (405) 395-9050
3400 W Tecumseh Rd
Suite 100
Norman, OK 73072-1810
Phone (405) 307-6900
6001 NW 139TH St
Suite a
Oklahoma City, OK 73142-1919
Phone (405) 635-3511
8100 S Walker Ave
BLDG a
Oklahoma City, OK 73139-9475
8100 S Walker Ave BLDG a
Southwest Orthopaedic and Reconstructive
Oklahoma City, OK 73139-9475
Phone (405) 632-4468
Hospital & facility affiliations
- Community Hospital, LLC
- Oklahoma Center for Orthopaedic & Multi-SP
- Integris Canadian Valley Hospital
- Integris Baptist Medical Center, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.92 of 100
- Quality
- 56.21
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 66.86
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040420001587 | OK | Practitioner - Physician Assistant | 3870589500 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1341 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Immediate Care of Oklahoma LLC | Current |
Accepting new patients | |
| Southwest Orthopaedic Specialists, PLLC | Current |
Accepting new patients | |
| Southwest Orthopaedic Specialists, PLLC | Current |
Accepting new patients | |
| Oca MWC LP | Past | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients | |
| Community Hospital LLC | Past | Accepting new patients | |
| Oklahoma Clinical Associates LLC | Past | Accepting new patients | |
| Southwest Orthopaedic Specialists, P.L.L.C. | Past | Accepting new patients | |
| Rock Creek Clinic, LP | Past | Accepting new patients | |
| Oca Tricity LP | Past | Accepting new patients | |
| Oca 1 LLC | Past | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
800 24th Ave NW
Norman, OK 73069
Phone (405) 321-7100
3321 W Tecumseh Rd
Ste 125
Norman, OK 73072
Phone (405) 307-6900
8100 S Walker Ave
Bldg A
Oklahoma City, OK 73139
11808 S May Ave
Oklahoma City, OK 73170
Phone (405) 735-2370
6001 NW 139th St
Ste A
Oklahoma City, OK 73142
Phone (405) 635-3511
2506 N Harrison St
Shawnee, OK 74804
Phone (405) 214-0300
1805 Commons Cir
Ste 100C
Yukon, OK 73099
Phone (405) 265-0165
Interoperability endpoints
- khollingsworth70115@direct.integrisok.com
- khollingsworth@direct.uspi.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1341 | OK | |
| Medical Physician Assistant | 363AM0700X | 1341 | OK | |
| Physician Assistant | 363A00000X | 1341 | OK | Yes |
Addresses
Primary practice location
8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475
Mailing address
8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475
Phone (405) 632-4468
Other practice location 1
1805 Commons Cir Ste 100-C
Yukon, OK 73099-9519
Phone (405) 265-0165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1341 | Other | OK | MEDICAL LICENSE |
Other providers in Oklahoma City, OK
- Stephanie Denise Hollier
- Sheridan Denae Hollifield
- Brent Keith Holliman
- Alan B. Hollingsworth
- Bonnie L Hollingsworth
- Michelle Hollingsworth
- Susan Lea Hollingsworth
- Breya Hollins
- William Hollins
- Felicia Ave Hollis
All providers in Oklahoma City, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.