NPIMap

Individual provider Active NPI

Kyle V McGivern, DO

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1851685747
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
5293 Issued in OK
Practice address
3130 SW 89TH St Ste 200
Oklahoma City, OK 73159-7909
Phone
(972) 846-0837
Fax
(214) 764-3113
NPI assigned
Jun 8, 2011
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5293 OK
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 5293 OK Primary

Addresses

Primary practice location

3130 SW 89TH St Ste 200
Oklahoma City, OK 73159-7909

Mailing address

3705 NW 63Rd St Ste 201
Oklahoma City, OK 73116-1937
Phone (405) 297-4968

Other practice location 1

3705 NW 63rd St Ste 201
Oklahoma City, OK 73116-1937
Phone (405) 297-4968

Other identifiers 1

IdentifierTypeStateIssuer
5293OtherOKMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170628000982 OK Practitioner - Orthopedic Surgery 3971894585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sho Professional Services LLCGroup PAC ID 7810366051, 4 clinicians

Practice addresses (Care Compare)

2029 Gordon Cooper Dr
Shawnee, OK 74801-9005
Phone (405) 878-5850

3130 SW 89TH St
Suite 200
Oklahoma City, OK 73159-7909
Phone (888) 957-7463

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement24
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5293OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sho Professional Services LLC Orthopaedic Surgery CurrentSince Jan 1, 2024 Accepting new patients
Absentee Shawnee Tribal Health Authority, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Surgical Hospital of Oklahoma LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients

Locations

15951 Little Axe Dr
Norman, OK 73026
Phone (405) 447-0300

3130 SW 89th St
Ste 200
Oklahoma City, OK 73159
Phone (405) 645-5475

3705 NW 63rd St
Ste 201
Oklahoma City, OK 73116
Phone (405) 673-3280

2029 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 878-4702

4409 N Kickapoo Ave
Shawnee, OK 74804
Phone (405) 242-4100

Organizations & group practices 6

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 9

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1851685747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161937",
            "telephone_number": "405-297-4968",
            "fax_number": "972-848-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SW 89TH ST STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597909",
            "telephone_number": "972-846-0837",
            "fax_number": "214-764-3113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 NW 63rd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731161937",
            "country_code": "US",
            "telephone_number": "405-297-4968",
            "fax_number": "972-848-5269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGIVERN",
        "first_name": "KYLE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "5293",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OK",
            "license": "5293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "5293",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.