Individual provider Active NPI

Kyla Renae Pyko, D.O.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1790912475
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02005086 Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02005086 IN Primary
General Practice Physician 208D00000X 5101018368 MI

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

2001 W. 86TH Street
Indianapolis, IN 46260-1902
Phone (317) 802-3140

Other practice location 1

301 Fisher St
Keesler AFB, MS 39534-2508
Phone (228) 376-4022

Other names 1

  • Kyla R. Henke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, AL2 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

Enrollment IDStateProvider typePAC IDDetails
I20170705002733 IN Practitioner - Emergency Medicine 2466721568 Reassigns benefits to 1 organization
I20231006001085 AL Practitioner - Emergency Medicine 2466721568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Nova Southeastern College of Osteo Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5542 Vanlerberghe LN
Trussville, AL 35173-2538
Phone (205) 971-3290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02005086INMDEmergency Medicine Physician
5101018368MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Trinity Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 28, 2023 Accepting new patients
Trinity Emergency Physicians LLC Emergency Medicine CurrentSince Aug 28, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

9613 E US Highway 36
Avon, IN 46123
Phone (317) 415-5980

1206 E National Ave
Brazil, IN 47834
Phone (812) 442-2480

10580 N Meridian St
Carmel, IN 46290
Phone (317) 338-2273

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

8451 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 884-7540

8602 Allisonville Rd
Indianapolis, IN 46250
Phone (317) 703-1970

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

412 N Monroe St
Williamsport, IN 47993
Phone (765) 762-2496

Organizations & group practices 5

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 1

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1790912475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W. 86TH STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-802-3140",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Fisher St",
            "address_purpose": "LOCATION",
            "city": "Keesler AFB",
            "state": "MS",
            "postal_code": "395342508",
            "country_code": "US",
            "telephone_number": "228-376-4022",
            "fax_number": "228-376-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PYKO",
        "first_name": "KYLA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02005086",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101018368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLA",
            "last_name": "HENKE",
            "middle_name": "R.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.