MR. KYLE SHORT – Mental Health Counselor, NPI 1073199048

MR. KYLE SHORT is a healthcare provider. based in Boynton beach, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. IMH17305 (FL). The NPI Number for MR. KYLE SHORT is 1073199048

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
MR. KYLE SHORT
NPI
1073199048
Phone
(561) 770-1780
Address
2500 QUANTUM LAKES DR STE 105
Enumeration Date
22 March 2021
Last Update Date
22 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7864146666
Graduation Year
2018 (8 years ago)
PAC ID
4082056189
Group Practice PAC ID
7517480577
Professional Enrollment ID
I20240521001953
Address ID
FL334014849WE111XXDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for MR. KYLE SHORT

  • 2500 QUANTUM LAKES DR STE 105

    BOYNTON BEACH, FL 334268308

    Phone: (561) 770-1780

    Fax: (833) 562-8893

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-05-21

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
I20240521001953IMental Health CounselorFLTBD

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 33426)

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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: 7517480577View full group profile
NameSpecialtyState
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Mental Health CounselorFL
Clinical Social WorkerFL
Mental Health CounselorFL
Clinical PsychologistFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Mental Health CounselorFL

Reviews

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Frequently asked questions

Is MR. KYLE SHORT listed with a National Provider Identifier?
Yes — MR. KYLE SHORT has NPI 1073199048 on file in the registry.
Is there an active status for MR. KYLE SHORT?
For scheduling context, MR. KYLE SHORT is shown as active in the registry.
What expertise is attributed to MR. KYLE SHORT?
MR. KYLE SHORT's specialty line reads Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What locale is associated with MR. KYLE SHORT?
Directory geography for MR. KYLE SHORT centers on Boynton Beach, Florida.
Can I trust this NPI listing for MR. KYLE SHORT?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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