Provider Type Icon

MR. KYLE JACOB HAVERCROFT PA-C NPI 1700063344


NPI Information

NPI: 1700063344
Provider Name: MR. KYLE JACOB HAVERCROFT, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
1107 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 667-7459
Get Directions

MR. Kyle Jacob Havercroft, PA-C is a surgical physician assistant in Coeur D Alene, ID with 9 years of experience. MR. Kyle Jacob Havercroft, PA-C NPI is 1700063344. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1107 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814-604
Phone: (208) 667-7459
Fax: (208) 667-2631

The NPI 1700063344 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • X-ray of hip with pelvis, 2-3 views (HCPCS:73502)
  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

The enumeration date for this NPI number is 1/25/2008 and was last updated on 10/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedicalPA-1313IDAHONo
2363A00000XPhysician AssistantPA-1313IDAHONo
3363AS0400XPhysician AssistantSurgicalPA-1313IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
120009691MEDICARE PINIDAHO
220007951MEDICARE PINIDAHO
31083729438OTHERLINKED TO OSSM ORGANIZATION
41374148MEDICARE PINIDAHO
520007950MEDICARE PINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.