Individual provider Active NPI

Kyle T Pearson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Morris, IL
National Provider Identifier
1780971598
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006321 Issued in PA
Practice address
1051 W US Route 6
Suite 100
Morris, IL 60450-4200
Phone
(815) 942-4875
Fax
(815) 942-5046
NPI assigned
Jun 30, 2011
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006321 PA Primary

Addresses

Primary practice location

1051 W US Route 6
Suite 100
Morris, IL 60450-4200

Mailing address

725 School St Ste a
Morris, IL 60450-1207
Phone (815) 941-9124

Other identifiers 1

IdentifierTypeStateIssuer
016.005600OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000704 IL Practitioner - Podiatry 6204050511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

1051 W US Route 6
Morris, IL 60450-4200
Phone (815) 942-4875

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue20
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006321PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince May 3, 2021 Accepting new patients
Morris Hospital CurrentSince May 3, 2021 Accepting new patients
Morris Hospital Current Accepting new patients

Locations

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

27240 W Saxony Dr
Ste 201
Channahon, IL 60410
Phone (815) 467-1518

1310 Houbolt Rd
Joliet, IL 60431
Phone (815) 741-4000

1051 W US Route 6
Morris, IL 60450
Phone (815) 318-5666

1051 W US Route 6
Ste 10
Morris, IL 60450
Phone (815) 942-4875

1051 W US Route 6
Ste 100
Morris, IL 60450
Phone (815) 942-4875

1051 W US Route 6
Ste 400
Morris, IL 60450
Phone (815) 942-8301

150 W High St
Morris, IL 60450
Phone (815) 942-2129

725 School St
Ste A
Morris, IL 60450

1306 Gemini Cir
Ste 2
Ottawa, IL 61350
Phone (815) 431-9980

Interoperability endpoints

  • Direct secure messaging: kyle.pearson@direct-address.org

Organizations & group practices 4

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1780971598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W US ROUTE 6",
            "address_2": "SUITE 100",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604504200",
            "telephone_number": "815-942-4875",
            "fax_number": "815-942-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "KYLE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "016.005600",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

Verify at the official NPI Registry.