Active NPI
Kyle Alexander Derrick Williams, MD
- Dermatology Physician
- The Villages, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME164450
- Practice address
- 1050 Old Camp Rd Ste 150
The Villages, FL 32162-1723 - Phone
- (352) 399-7295
- Fax
- (352) 399-7294
- NPI assigned
- Mar 22, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | TRN35904 | FL | |
| Dermatology Physician | 207N00000X | ME164450 | FL | Primary |
Addresses
Primary practice location
1050 Old Camp Rd Ste 150
The Villages, FL 32162-1723
Mailing address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other practice location 1
10946 County Road 100
The Villages, FL 32162-3604
Phone (352) 399-7295
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kwilliams1455981@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Hospital & facility affiliations
- Mayo Clinic
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.24 of 100
- Quality
- 74.85
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.62
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 98 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 75 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN35904 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1871054106
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1891782470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1982353306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 OLD CAMP RD STE 150",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "321621723",
"telephone_number": "352-399-7295",
"fax_number": "352-399-7294"
}
],
"practiceLocations": [
{
"address_1": "10946 County Road 100",
"address_purpose": "LOCATION",
"city": "The Villages",
"state": "FL",
"postal_code": "321623604",
"country_code": "US",
"telephone_number": "352-399-7295",
"fax_number": "352-399-7294",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KYLE",
"middle_name": "ALEXANDER DERRICK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-22",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "TRN35904",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME164450",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kwilliams1455981@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "4500 San Pablo Rd S",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322241865",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in The Villages, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.