Kyle Groom (NPI# 1063413656, PAC ID# 2264424456) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1063413656 |
| PAC ID by PECOS | 2264424456 |
| Professional Enrollment ID | I20040330001205 |
| Full Name | Kyle Groom |
| Organization Legal Name | DEKALB PHYSICIANS CLINIC LLC |
| Address |
216 N Centre St Dekalb Phyisians Clinic Dekalb TX 75559-1406 |
| Phone Number | 9036672273 |
| Gender | M |
| Credential | DO |
| Medical School | UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH |
| Graduation Year | 1999 |
| Primary Specialty | EMERGENCY MEDICINE |
| Secondary Specialties | FAMILY MEDICINE |
| Group Practice PAC ID | 0244264216 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450801 | CHRISTUS ST MICHAEL HEALTH SYSTEM |
| 450200 | WADLEY REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 216 N Centre St, Dekalb Phyisians Clinic, Dekalb, TX 75559-1406 | 9036672273 | DEKALB PHYSICIANS CLINIC LLC |
| 3002 Moores Ln, Texarkana, TX 75503-2204 | 4302004350 | MIDSOUTH TRANSITIONS MEDICAL GROUP |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_065_overall | Appropriate Treatment for Children with Upper Respiratory Infection (URI) | 68% |
| Organization Legal Name | DEKALB PHYSICIANS CLINIC LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Almer Hadaway | Nurse Practitioner | Dekalb Physicians Clinic LLC | 216 N Centre St, Dekalb Phyisians Clinic, Dekalb, TX 75559-1406 |
| Street Address |
216 N CENTRE ST DEKALB PHYISIANS CLINIC |
| City | DEKALB |
| State | TX |
| Zip | 75559-1406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Almer Hadaway | Nurse Practitioner | Dekalb Physicians Clinic LLC | 216 N Centre St, Dekalb Phyisians Clinic, Dekalb, TX 75559-1406 |
| City | DEKALB |
| Zip Code | 75559 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | DEKALB + EMERGENCY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.