Lauren Ann Kyle Tkachuk, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

04-36968 Issued in KS

Practice address

7840 W 165TH St Ste 260
Overland Park, KS 66223-3020

Phone

(913) 871-8221

Fax

(913) 273-0337

NPI assigned

May 2, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Lauren Ann Kyle Professional name

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Dermatology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Valley Dermatology LLCGroup PAC ID 9133499973, 12 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

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.

• Blue Valley Dermatology LLC

  • Dermatology Physician
  • Overland Park, KS
  • NPI 1104354794
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1760709679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 W 165TH ST STE 260",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233020",
            "telephone_number": "913-871-8221",
            "fax_number": "913-273-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE TKACHUK",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "04-36968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "KYLE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stacie Lee Kusters, M.A. LPC
• Brenda Sue Kutterer, CRNA
• Amber Belinda Kuykendall, LMSW
• Sarah Kwapiszeski, DPT
• Sharon Kwon, LPC
• L&E Initiatives LLC
• Lab One Inc
• Rebecca A Labat, LMSW
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings

• Dermatology Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.