DR. KYLE HAVERSTROM (DPM) – Podiatrist, NPI 1649791369
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
67 PODIATRY in AR
Provider Addresses for DR. KYLE HAVERSTROM (DPM)
200 S 20TH ST STE B
ROGERS, AR 727581100
Phone: (479) 636-9393
Type: Mailing
15815 SHADDOCK DR STE 130
WINTER GARDEN, FL 347875773
Phone: (813) 400-1140
Fax: (813) 701-9132
Type: Mailing
11200 SEMINOLE BLVD STE 305
LARGO, FL 337783239
Phone: (727) 431-9552
Fax: (727) 290-4376
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $2,101.
Total Amount is formed as General ($2,101) + Research ($0) + Ownership ($0) = $2,101.
Last reported payment date: 2024-12-21 • Largest payer in this snapshot: Stryker Corporation ($1,344).
Total Amount
$2,101
General + Research + Ownership
Payments
29
Total payment records
General Amount
$2,101
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210726002208 | I | Podiatry | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11721 | Removal of fingernails or toenails, 6 or more nails | 167 | 81 | $0 |
| 11056 | Removal of noncancer thickened skin growth, 2-4 growths | 144 | 67 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 100 | 64 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 92 | 56 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 88 | 18 | $0 |
Insurance plans in this area (ZIP 72758)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | MI | |
| P O D I A T R Y | NJ | |
| P O D I A T R Y | FL | |
| P O D I A T R Y | FL | |
| P O D I A T R Y | FL | |
| P O D I A T R Y | FL | |
| P O D I A T R Y | KY | |
| P O D I A T R Y | FL | |
| P O D I A T R Y | FL | |
| Physical Therapist In Private Practice | FL |
Reviews
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