ZACHARY KYLE (MSW, LCSW) – Clinical Social Worker, NPI 1104294180
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,711 CLINICAL SOCIAL WORKER in IN
Provider Addresses for ZACHARY KYLE (MSW, LCSW)
3512 STELLHORN RD
FORT WAYNE, IN 46815
Phone: (260) 483-9081
Fax: (260) 493-9196
Type: Location
330 Lakeview Dr
Goshen, IN 465289365
Phone: (574) 533-1234
Fax: (574) 537-2652
Type: Location
311 S EDDY ST
SOUTH BEND, IN 466173201
Phone: (574) 213-2456
Type: Mailing
PO BOX 392552
PITTSBURGH, PA 152519500
Phone: (512) 575-8028
Type: Mailing
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: 2023-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20190708001034 | I | Clinical Social Worker | IN | TBD |
| I20210426001146 | I | Clinical Social Worker | OH | TBD |
| I20230726000192 | I | Clinical Social Worker | KS | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46815)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KS | |
| Clinical Social Worker | KS | |
| Clinical Psychologist | KS | |
| Mental Health Counselor | KS | |
| Clinical Social Worker | KS | |
| Clinical Social Worker | KS | |
| Mental Health Counselor | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | KS |
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