Individual provider Active NPI

Kyle Kjome, D.O.

  • Anesthesiology Physician
  • Pittsburgh, PA
National Provider Identifier
1750793535
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23919 Issued in MS
Practice address
320 E North Ave
Allegheny General Hospital
Pittsburgh, PA 15212-4756
Phone
(412) 359-6726
NPI assigned
May 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Anesthesiology Physician 207L00000X 23919 MS Primary
Anesthesiology Physician 207L00000X 032-0133890 VT
General Practice Physician 208D00000X 23919 MS
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

320 E North Ave
Allegheny General Hospital
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Allegheny General Hospital
Pittsburgh, PA 15212-4756

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other identifiers 2

IdentifierTypeStateIssuer
00224574MedicaidMS
435134OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20150916000226 MS Practitioner - General Practice 2264746031 Reassigns benefits to 1 organization
Practice locations: Biloxi, MS

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson County AnesthesiaGroup PAC ID 9931292729, 37 clinicians

Practice addresses (Care Compare)

3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone (228) 818-1100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032-0133890VTMDAnesthesiology Physician
23919MSMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia State Anesthesia Services, PLLC Anesthesiology CurrentSince Jan 8, 2024 Accepting new patients
Jackson County Anesthesia Anesthesiology CurrentSince Mar 1, 2022 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

2406 Catalpa Ave
Pascagoula, MS 39567
Phone (228) 202-1006

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1750793535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "address_2": "ALLEGHENY GENERAL HOSPITAL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "address_2": "ALLEGHENY GENERAL HOSPITAL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KJOME",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "23919",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "032-0133890",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "23919",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00224574",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "435134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.