Kyle Brian Burghgraef, is a medicare enrolled "Pediatrics" physician in South Bloomfield, Ohio. His current practice location is
5030 N Walnut St, South Bloomfield, Ohio. You can reach out to his office (for appointments etc.) via phone at
(740) 983-0015.
Kyle Brian Burghgraef is licensed to practice in Ohio (license number 35139089) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497286629.
Physician's Profile
| Full Name | Kyle Brian Burghgraef |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 5030 N Walnut St, South Bloomfield, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497286629
- Provider Enumeration Date: 03/21/2017
- Last Update Date: 02/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 2567733876
- Enrollment ID: I20200512003649
Medical Identifiers
Medical identifiers for Kyle Brian Burghgraef such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497286629 | NPI | - | NPPES |
| 0396565 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2080P0204X | Pediatrics - Pediatric Emergency Medicine | 35139089 (Ohio) | Secondary |
| 208000000X | Pediatrics | 35139089 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kyle Brian Burghgraef allows following entities to bill medicare on his behalf.
| Entity Name | Childrens Community Practices Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386031896
PECOS PAC ID: 5092047084
Enrollment ID: O20191023003502 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kyle Brian Burghgraef is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kyle Brian Burghgraef,
700 Childrens Dr,
Columbus, OH 43205-2664
Ph: (614) 722-2000 | Kyle Brian Burghgraef,
5030 N Walnut St,
South Bloomfield, OH 43103-1018
Ph: (740) 983-0015 |
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