KYLE GREEN (PA-C) – Surgical Physician Assistant, NPI 1194246041

KYLE GREEN (PA-C) is a healthcare provider. based in Rancho santa margarita, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for KYLE GREEN (PA-C) is 1194246041

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
KYLE GREEN (PA-C)
NPI
1194246041
Phone
(855) 727-2251
Address
22431 ANTONIO PKWY # B160-613
Enumeration Date
30 June 2017
Last Update Date
10 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8557272251
Graduation Year
2017 (9 years ago)
PAC ID
1254718182
Group Practice PAC ID
1355791997
Professional Enrollment ID
I20220516002011
Address ID
CA926882804RA22431PKWY301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:8State licenses:0Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

Provider Addresses for KYLE GREEN (PA-C)

  • 22431 ANTONIO PKWY # B160-613

    RANCHO SANTA MARGARITA, CA 926882804

    Phone: (855) 727-2251

    Fax: (855) 727-2251

    Type: Location

  • 1190, 5th Avenue, Watervliet, City of Watervliet, Albany County, New York, 12189, United States

    GUGGENHEIM PAVILION-TWO WEST

    NEW YORK, NY 10029

    Phone: (212) 659-6800

    Fax: (212) 659-6818

    Type: Mailing

  • Mount Sinai Emergency Medicine, 1190, 5th Avenue, Manhattan Community Board 11, Manhattan, New York County, New York, 10035, United States

    NEW YORK, NY 100296503

    Phone: (212) 659-6800

    Fax: (212) 659-6818

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 30 Open Payments records for all available years, with a total value of $1,345.

Total Amount is formed as General ($1,345) + Research ($0) + Ownership ($0) = $1,345.

Last reported payment date: 2024-10-04 • Largest payer in this snapshot: ATRICURE, INC. ($513).

Total Amount

$1,345

General + Research + Ownership

Payments

30

Total payment records

General Amount

$1,345

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-05-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220516002011IPhysician AssistantCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92688)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355791997View full group profile
NameSpecialtyState
Physician AssistantCA
Physician AssistantNJ
Physician AssistantIN
Physician AssistantCA
Physician AssistantCA
Physician AssistantCA

Reviews

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Frequently asked questions

What identifier follows KYLE GREEN (PA-C) across health systems?
The NPI 1194246041 uniquely identifies KYLE GREEN (PA-C) in U.S. healthcare data.
Is KYLE GREEN (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists KYLE GREEN (PA-C) as active.
Which specialty label fits KYLE GREEN (PA-C)?
NPPES ties KYLE GREEN (PA-C) to Surgical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to KYLE GREEN (PA-C)?
KYLE GREEN (PA-C) shows a connection to Rancho Santa Margarita, California in registry-derived data.
Can I export KYLE GREEN (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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