KYLE J BENNER (M.D.) – Psychiatry Physician, NPI 1023242708
Psychiatry Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KYLE J BENNER (M.D.)
PO BOX 25608
SALT LAKE CITY, UT 841250608
Phone: (206) 320-4476
Fax: (206) 569-7043
Type: Mailing
1100 9TH AVE
M4-PFS
SEATTLE, WA 981012756
Phone: (206) 515-5811
Fax: (206) 341-0274
Type: Mailing
2671 NE 46TH ST
SEATTLE, WA 981055041
Phone: (206) 525-8000
Fax: (206) 525-8070
Type: Location
7320 216th St SW Ste 200
Edmonds, WA 980268006
Phone: (425) 640-4900
Fax: (425) 640-4919
Type: Location
216th Street Southwest, Edmonds, Snohomish County, Washington, 98026, United States
EDMONDS, WA 980268006
Phone: (425) 640-4900
Fax: (425) 640-4919
Type: Location
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: 2015-09-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150916000937 | I | Child And Adolescent Psychiatry | WA | 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 84125)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | WA | 90792 | Psychiatric diagnostic evaluation with medical services | 23 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | UT | |
| - | UT | |
| - | WA | |
| - | WA | |
| Family Practice | UT | |
| - | UT | |
| - | WA | |
| - | WA | |
| - | WA | |
| - | WA |
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