Kyle White

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61705 Issued in CA

Practice address

5565 Grossmont Center Dr
La Mesa, CA 91942-3020

Phone

(619) 464-3353

NPI assigned

Dec 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Nose and Throat Associates of San Diego a Medical CorpGroup PAC ID 0345290094, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Merit-based Incentive Payment System (MIPS)

Final score

99.5 of 100Reported as group

Quality

89

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Ear Nose and Throat Associates of San Diego a Medical Corp

  • Specialist
  • La Mesa, CA
  • NPI 1811992761
  Medicare reassignment Care Compare group
• University of Detroit Mercy

  • General Practice Physician
  • Detroit, MI
  • NPI 1669187696
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1922768860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 EASTON RD",
            "city": "NEW LOTHROP",
            "state": "MI",
            "postal_code": "484609716",
            "telephone_number": "810-247-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-464-3353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 W McNichols Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482213038",
            "country_code": "US",
            "telephone_number": "313-993-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT BOARD OF CALIFORNIA",
            "identifier": "PA61705",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Westmont Living, Inc.
• Jessica Wheeles
• Amy Gibbs White, AMFT
• Jeffrey White, MD
• Kayunique White
• Stephen Donald White, DDS
• Lynn Marie Whiteaker, MFT
• Kathleen Breann Whitefield, AMFT
• Whitney Carter Professional Clinical Counselor
• Patricia Kim Whitson, LCSW

• Physician Assistant in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.