KYLE WAYNE HERBOLD (M.D.) – Dermatology Physician, NPI 1568407013

KYLE WAYNE HERBOLD (M.D.) is a healthcare provider. based in Stockton, California. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. A068815 (CA). The NPI Number for KYLE WAYNE HERBOLD (M.D.) is 1568407013

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
KYLE WAYNE HERBOLD (M.D.)
NPI
1568407013
Phone
(209) 951-1133
Address
4553 QUAIL LAKES DR
Enumeration Date
18 June 2006
Last Update Date
13 July 2007

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2099244086
Graduation Year
1995 (31 years ago)
PAC ID
5799766796
Group Practice PAC ID
1052418175
Professional Enrollment ID
I20041021001093
Address ID
CA953364935MA200XXAVEX304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,141 DERMATOLOGY in CA

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Provider Addresses for KYLE WAYNE HERBOLD (M.D.)

  • 4553, Quail Lakes Drive, Stockton, San Joaquin County, California, 95207, United States

    STOCKTON, CA 95207

    Phone: (209) 951-1133

    Fax: (209) 951-4708

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 88 Open Payments records for all available years, with a total value of $1,611.

Total Amount is formed as General ($1,611) + Research ($0) + Ownership ($0) = $1,611.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Lilly USA, LLC ($320).

Total Amount

$1,611

General + Research + Ownership

Payments

88

Total payment records

General Amount

$1,611

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

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: 2004-10-21

PECOS data refreshed: 2026-06-15

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
I20041021001093IDermatologyCATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,838307$0
99213Established patient office or other outpatient visit, 20-29 minutes1,123799$0
17110Destruction of skin growth, 1-14 growths617477$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg547111$0
17000Destruction of precancer skin growth, 1 growth504399$0
View full utilization report →

Insurance plans in this area (ZIP 95207)

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Provider's Procedures

KYLE WAYNE HERBOLD (M.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYCA11101Biopsy of each additional growth of skin and/or tissue1514

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: 1052418175View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
D E R M A T O L O G YCA
D E R M A T O L O G YCA
D E R M A T O L O G YCA
O T O L A R Y N G O L O G YCA
D E R M A T O L O G YCA
Physician AssistantCA
D E R M A T O L O G YCA
D E R M A T O L O G YCA
Physician AssistantGA

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Frequently asked questions

What federal number belongs to KYLE WAYNE HERBOLD (M.D.)?
The federal identifier for KYLE WAYNE HERBOLD (M.D.) is NPI 1568407013.
Is KYLE WAYNE HERBOLD (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize KYLE WAYNE HERBOLD (M.D.)'s specialty in plain language?
Clinically, the directory lists KYLE WAYNE HERBOLD (M.D.) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place KYLE WAYNE HERBOLD (M.D.)?
The snapshot lists Stockton, California for KYLE WAYNE HERBOLD (M.D.); download NPPES for the complete set.
How can I contact KYLE WAYNE HERBOLD (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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