Individual provider Active NPI

Kyle Christian Dornhofer

  • Emergency Medicine Physician
  • Orange, CA
National Provider Identifier
1942836812
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A177990 Issued in CA
Practice address
101 The City Drive S
Rte. 128-01
Orange, CA 92868
Phone
(714) 456-8116
NPI assigned
Mar 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X STUDENT CA
Emergency Medicine Physician 207P00000X A177990 CA Primary

Addresses

Primary practice location

101 The City Drive S
Rte. 128-01
Orange, CA 92868

Mailing address

101 The City Drive S
Rte. 128-01
Orange, CA 92868

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230508002451 CA Practitioner - Emergency Medicine 1153708813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177990CAMDEmergency Medicine Physician
STUDENTCAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

345 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 489-4261

751 Medical Center Ct
#1182
Chula Vista, CA 91911

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
#12801
Orange, CA 92868
Phone (714) 456-5239

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

Interoperability endpoints

  • Direct secure messaging: kdornhofer181273@direct.renown.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1942836812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE S",
            "address_2": "RTE. 128-01",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE S",
            "address_2": "RTE. 128-01",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNHOFER",
        "first_name": "KYLE",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "STUDENT",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A177990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.