NPIMap

Individual provider Active NPI

Kyle F. Dickson, MD, MBA

  • Orthopaedic Trauma Physician
  • Houston, TX
National Provider Identifier
1942302997
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
N0733 Issued in TX
Practice address
6560 Fannin St
Suite 1016
Houston, TX 77030-2761
Phone
(713) 800-1080
Fax
(713) 800-1081
NPI assigned
Sep 1, 2006
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X N0733 TX Primary

Addresses

Primary practice location

6560 Fannin St
Suite 1016
Houston, TX 77030-2761

Mailing address

6560 Fannin St
Suite 1016
Houston, TX 77030-2761
Phone (713) 800-1080

Other identifiers 1

IdentifierTypeStateIssuer
1843351-03MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070209000564 TX Practitioner - Orthopedic Surgery 7911932488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, San Diego School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6560 Fannin St
Suite 1016
Houston, TX 77030-2725
Phone (713) 610-4270

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement14
Knee replacement11
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
518LAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Feb 1, 2012 Accepting new patients
Southwest Orthopedic Group, LLP CurrentSince Feb 23, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Feb 1, 2012 Accepting new patients
Southwest Orthopedic Group, LLP Orthopaedic Trauma CurrentSince Feb 23, 2011 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

3711 Garth Rd
Ste E
Baytown, TX 77521
Phone (713) 610-4270

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6560 Fannin St
Ste 1016
Houston, TX 77030
Phone (713) 610-4270

10970 Shadow Creek Pkwy
Ste 130
Pearland, TX 77584
Phone (713) 610-4270

1350 Creek Way Dr
Sugar Land, TX 77478
Phone (713) 610-4270

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/256/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/6286/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kyle.dickson.1@13131.direct.athenahealth.com
  • Direct secure messaging: kyle.dickson.1@256.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1942302997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "SUITE 1016",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302761",
            "telephone_number": "713-800-1080",
            "fax_number": "713-800-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "SUITE 1016",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302761",
            "telephone_number": "713-800-1080",
            "fax_number": "713-800-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "KYLE",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TX",
            "license": "N0733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1843351-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.