Kyle Elizabeth Benson, PA
Individual provider Active NPI Physician Assistant · Albuquerque, NM
NPI 1720611544 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1720611544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2023-0035 (NM)
- Practice address
- 11601 Montgomery Blvd NE
Albuquerque, NM 87111-2660 - Phone
- (505) 814-1995
- NPI assigned
- Feb 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Privia Medical Group of Georgia LLC
Practice addresses (Care Compare)
101 Yorktown Dr
Fayetteville, GA 30214-1578
3235 S Cherokee Lane
BLDG 1200
Woodstock, GA 30188-7026
Phone (678) 384-4911
3400 Old Milton Pkwy
Alpharetta, GA 30005-3707
Phone (678) 384-4911
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.29 of 100
- Quality
- 71.09
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.53
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20241106000213 | GA | Practitioner - Physician Assistant | 7719345560 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients |
Locations
3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
3217 S Cherokee Ln
Ste 730
Woodstock, GA 30188
Phone (678) 384-4911
Interoperability endpoints
- kyle.benson.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA2023-0035 | NM | Yes |
Addresses
Primary practice location
11601 Montgomery Blvd NE
Albuquerque, NM 87111-2660
Mailing address
4985 Stablegate CT
Cumming, GA 30028-7967
Phone (770) 856-4704
Other practice location 1
4985 Stablegate Ct
Cumming, GA 30028-7967
Phone (770) 856-4704
Other providers in Albuquerque, NM
- Jennifer Beno
- Tambra Bensch
- Aja Benson
- Amy Corinne Benson
- Jennifer Benson
- Patricia Benson
- Marie L Bensulock
- Cara Benta
- Molly Benthal
- Brydie Bentley
All providers in Albuquerque, NM · Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. 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.