DR. KENNETH JON KYSOR (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1073072112

DR. KENNETH JON KYSOR (DPM) is a healthcare provider. based in Cincinnati, Ohio. specializing in PODIATRY. They hold the professional credentials DPM. They hold a License No. 330032 (LA). The NPI Number for DR. KENNETH JON KYSOR (DPM) is 1073072112

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH JON KYSOR (DPM)
NPI
1073072112
Phone
Not provided
Address
10500 MONTGOMERY RD
Enumeration Date
18 March 2019
Last Update Date
14 April 2023

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
3182406000
Graduation Year
2019 (7 years ago)
PAC ID
0648505081
Group Practice PAC ID
9032254685
Professional Enrollment ID
I20220614000025
Address ID
LA713514711MA4231X1192300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

953 PODIATRY in OH

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Provider Addresses for DR. KENNETH JON KYSOR (DPM)

  • Montgomery Road, O’Bryonville, Evanston, Cincinnati, Hamilton County, Ohio, 45207, United States

    CINCINNATI, OH 452424402

    Phone:

    Type: Mailing

  • 5541 HIGHWAY 1

    MARKSVILLE, LA 713512650

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 22 Open Payments records for all available years, with a total value of $2,942.

Total Amount is formed as General ($2,942) + Research ($0) + Ownership ($0) = $2,942.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Stryker Corporation ($2,753).

Total Amount

$2,942

General + Research + Ownership

Payments

22

Total payment records

General Amount

$2,942

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

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: 2022-06-14

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
I20220614000025IPodiatryLATBD

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 45242)

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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: 9032254685View full group profile
NameSpecialtyState
Family PracticeLA
N E U R O L O G YLA
Critical Care (Intensivists), Pulmonary Disease, Thoracic SurgeryLA
Family PracticeLA
Diagnostic Radiology, Interventional RadiologyVA
Family PracticeLA
P O D I A T R YLA
Interventional Cardiology, Cardiovascular Disease (Cardiology)LA
Orthopedic SurgeryLA
Diagnostic RadiologyCT

Reviews

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Frequently asked questions

Is DR. KENNETH JON KYSOR (DPM) listed with a National Provider Identifier?
Yes — DR. KENNETH JON KYSOR (DPM) has NPI 1073072112 on file in the registry.
Active or inactive — what applies to DR. KENNETH JON KYSOR (DPM)?
You should see DR. KENNETH JON KYSOR (DPM) as active in CMS-hosted NPPES data.
What kind of doctor is DR. KENNETH JON KYSOR (DPM)?
DR. KENNETH JON KYSOR (DPM) is associated with Foot & Ankle Surgery Podiatrist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. KENNETH JON KYSOR (DPM)?
Directory geography for DR. KENNETH JON KYSOR (DPM) centers on Cincinnati, Ohio.
Can I trust this NPI listing for DR. KENNETH JON KYSOR (DPM)?
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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