Kyle David Peterson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

N4663 Issued in TX

Practice address

3600 Gates Blvd
Port Arthur, TX 77642-3858

Phone

(800) 893-9698

NPI assigned

Nov 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Emergency Medicine

Education

University of Texas Medical School at San Antonio, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Care Medical, PLLCGroup PAC ID 5799040754, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.peterson@tcbc.eclinicaldirectplus.com

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.

• Total Care Medical, PLLC

  • Multi-Specialty Clinic/Center
  • Bridge City, TX
  • NPI 1811495575
  Medicare reassignment Care Compare group
• Acorn Medical Home

  • Family Medicine Physician
  • Bridge City, TX
  • NPI 1457099558
  Medicare reassignment NPD
• Singleton Associates PA

  • Diagnostic Radiology Physician
  • Shenandoah, TX
  • NPI 1538107875
  NPD (past)

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1922335199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GATES BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776423858",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N4663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Arlene Patin
• Peace of Mind Counseling Service
• Peacock Heavenly Massage
• Kayla Marie Peltier, PHARM.D.
• Victoria Perry, MS. CFY-SLP
• Brandon Pham, PHARM D.
• Daniel Chuong Pham
• Kristine Pham
• Physicians Eye Surgery Center PLLC
• Pickard Gossett Sawisky LLP

• Emergency Medicine Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.