Kyle R Kaulback, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD042359L Issued in PA

Practice address

252 S 4TH St
Lebanon, PA 17042-6111

Phone

(717) 270-7500

NPI assigned

Feb 28, 2006

Last updated

Aug 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kkaulback@landmarkhealth-direct.org

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.

• Emergency Physician Specialists Inc

  • Emergency Medicine Physician
  • Davenport, FL
  • NPI 1912973850
  NPD (past)
• Regents of the University of California - Ucsd Medical Group

  dba UCSD Dept of Gastroenterology

  • Gastroenterology Physician
  • San Diego, CA
  • NPI 1336267137
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1902872831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N WYOMISSING AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196071936",
            "telephone_number": "570-621-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426111",
            "telephone_number": "717-270-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179013625",
            "country_code": "US",
            "telephone_number": "570-621-5064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAULBACK",
        "first_name": "KYLE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "PA",
            "license": "MD042359L",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD042359L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Karoscik
• Edwin Mark Kase, M.D.
• Stanley T Kastrava, LCSW
• Jenna Kauffman
• Alyson Taylor Kaufman, PSYD
• Mohammad Kazimi
• Amanda Lee Keenan, CRNP
• Barbara F Keenan, MD
• Donald James Keenan, P.T.
• Benjamin L Keener, PSYD

• Emergency Medical Services (Emergency Medicine) Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.