Physician Compare National (NPI:1689194920)

HEALTHCARE PROVIDER: KYLE D. BYRNE PHYSICIAN ASSISTANT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1689194920
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911263041
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171107000073
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BYRNE
	Individual professional last name
Provider First Name	KYLE
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4385558030
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1760 E FLORENCE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 120
	Group Practice or individual's line 2 address
City	CASA GRANDE
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	851224765
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5204261000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030112
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ARIZONA ORTHOPEDIC AND SURGICAL SPECIALTY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y