Kyle Justin Dubose, DO is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Kenosha, Wisconsin. He went to West Virginia School Of Osteopathic Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as Undersea And Hyperbaric Medicine. He is a member of the group practice Aurora Medical Group, Inc. and his current practice location is
10400 75th St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 942-5600.
Kyle Justin Dubose is licensed to practice in Wisconsin (license number 67393) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1285093104.
Physician's Profile
| Full Name | Kyle Justin Dubose |
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| Gender | Male |
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| Speciality | Undersea And Hyperbaric Medicine |
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| Experience | 11 Years |
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| Location | 10400 75th St, Kenosha, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kyle Justin Dubose attended and graduated from West Virginia School Of Osteopathic Medicine in 2013
NPI Data:
- NPI Number: 1285093104
- Provider Enumeration Date: 02/20/2016
- Last Update Date: 09/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 7517238447
- Enrollment ID: I20170810001236
Medical Identifiers
Medical identifiers for Kyle Justin Dubose such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1285093104 | NPI | - | NPPES |
| 100068480 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | 67393 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Aurora Medical Group, Inc. | 6709794258 | 3269 |
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 Justin Dubose allows following entities to bill medicare on his behalf.
| Entity Name | Aurora Medical Group, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725 |
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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 Justin Dubose 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 Justin Dubose, DO
2901 W Kinnickinnic River Pkwy Ste 309,
Milwaukee, WI 53215-3660
Ph: (414) 649-1292 | Kyle Justin Dubose, DO
10400 75th St,
Kenosha, WI 53142-7884
Ph: (262) 942-5600 |
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