Individual provider Active NPI

Kyle Stephenson

  • Orthopaedic Surgery Physician
  • Anderson, IN
National Provider Identifier
1750647608
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
02005437A Issued in IN
Practice address
3125 S Scatterfield Rd Ste 210
Anderson, IN 46013
Phone
(765) 298-4311
Fax
(765) 298-4312
NPI assigned
Apr 4, 2012
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 02005437A IN
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 02005437A IN Primary

Addresses

Primary practice location

3125 S Scatterfield Rd Ste 210
Anderson, IN 46013

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

333 Jordan Rd
Indianapolis, IN 46217-4007
Phone (317) 908-6458

Other identifiers 1

IdentifierTypeStateIssuer
300015335MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstephenson321054@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180807001736 IN Practitioner - Orthopedic Surgery 3678821709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview HospitalGroup PAC ID 1153216627, 209 clinicians

Practice addresses (Care Compare)

17600 Shamrock Blvd
Westfield, IN 46074-7002
Phone (317) 773-0760

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02005437AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Hospital CurrentSince Feb 1, 2024 Accepting new patients
Riverview Hospital Orthopaedic Surgery CurrentSince Feb 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

325 Westfield Rd
Ste C
Noblesville, IN 46060
Phone (317) 770-1700

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

17600 Shamrock Blvd
Westfield, IN 46074
Phone (317) 214-5555

Interoperability endpoints

  • Direct secure messaging: kstephenson321054@ecommunitydirect.com

Organizations & group practices 3

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 2

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1750647608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 S SCATTERFIELD RD STE 210",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "46013",
            "telephone_number": "765-298-4311",
            "fax_number": "765-298-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Jordan Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462174007",
            "country_code": "US",
            "telephone_number": "317-908-6458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "02005437A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "02005437A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015335",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstephenson321054@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "3125 S Scatterfield Rd Ste 210",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.