Kyle Kaltwasser

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD224801 Issued in OR

Practice address

1501 NE Medical Center Dr
Bend, OR 97701-6051

Phone

(541) 382-4900

NPI assigned

May 8, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, OR2 enrollments

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 2

Specialty

Dermatology

Education

University of Texas at Austin Dell Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Bend Memorial Clinic PC

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477

  Dermatology

  Medicare reassignment Care Compare group NPD
• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment NPD
• Bend Memorial Clinic PC

  • Clinical Medical Laboratory
  • Bend, OR
  • NPI 1972144913
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1750769949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "77555",
            "country_code": "US",
            "telephone_number": "409-747-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17300 El Camino Real Ste 103",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770582743",
            "country_code": "US",
            "telephone_number": "281-480-7546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "77555",
            "country_code": "US",
            "telephone_number": "409-747-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20311 Kuykendahl Rd",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "77379",
            "country_code": "US",
            "telephone_number": "832-717-3376",
            "fax_number": "832-717-0004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALTWASSER",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-08",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD224801",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R8921",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500863701",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R274147",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkaltwasser23199@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony M Kahr, M.D.
• Dacia Renee Kailin, PA-C
• Shaylynne Danielle Kalberg, LCSW
• Corrin Kalinich, RDN
• Brian Gene Kallus, DMD
• Shinjiro Charles Kamaya, M.D.
• Kristen Kampstra
• Lindsay Kandra, LPC
• David Henach Kane, M.D.
• Kristen Kane, MA, CCC-SLP

• Dermatology Physician in Bend, OR
• Providers in Bend, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.