NPIMap

Individual provider Active NPI

Kyle Evan Hollingsworth, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1700826419
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1341 Issued in 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
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1341 OK
Medical Physician Assistant 363AM0700X 1341 OK
Physician Assistant 363A00000X 1341 OK Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420001587 OK Practitioner - Physician Assistant 3870589500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Immediate Care of Oklahoma LLCGroup PAC ID 2668540774, 34 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
76.92 of 100Reported as group
Quality
56.21
Promoting interoperability
100
Improvement activities
40
Cost
66.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1341OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Immediate Care of Oklahoma LLC CurrentSince Jul 23, 2018 Accepting new patients
Southwest Orthopaedic Specialists, PLLC CurrentSince Apr 1, 2014 Accepting new patients
Immediate Care of Oklahoma CurrentSince Jul 23, 2018 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Community Hospital LLC Past Accepting new patients
Oklahoma Clinical Associates LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients
Rock Creek Clinic, LP Past Accepting new patients
Oca MWC LP Past Accepting new patients
Oca Tricity LP Past Accepting new patients
Oca 1 LLC Past Accepting new patients
Southwest Orthopaedic Specialists, P.L.L.C. Past Accepting new patients

Locations

3321 W Tecumseh Rd
Ste 125
Norman, OK 73072
Phone (405) 307-6900

3400 W Tecumseh Rd
Ste 100
Norman, OK 73072
Phone (405) 307-6900

800 24th Ave NW
Norman, OK 73069
Phone (405) 321-7100

11808 S May Ave
Oklahoma City, OK 73170
Phone (405) 735-2370

8100 S Walker Ave
Bldg A
Oklahoma City, OK 73139

Interoperability endpoints

  • Direct secure messaging: khollingsworth@direct.uspi.com
  • Direct secure messaging: khollingsworth70115@direct.integrisok.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1700826419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 S WALKER AVE BLDG A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399475",
            "telephone_number": "405-632-4468",
            "fax_number": "405-632-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 S WALKER AVE BLDG A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399475",
            "telephone_number": "405-632-4468",
            "fax_number": "405-632-0436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1805 Commons Cir Ste 100-C",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "730999519",
            "country_code": "US",
            "telephone_number": "405-265-0165",
            "fax_number": "405-265-0897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "KYLE",
        "middle_name": "EVAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1341",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1341",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.