Kyle Petty, MD in Evanston, IL - Medicare Anesthesiology

Kyle Petty, MD is a medicare enrolled "Anesthesiology" physician in Evanston, Illinois. His current practice location is 2650 Ridge Ave., Dept. Of Anesthesia, Evanston, Illinois. You can reach out to his office (for appointments etc.) via phone at (847) 570-2760.

Kyle Petty is licensed to practice in Illinois (license number 036159935) 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 1104310630.

Contact Information

	Kyle Petty, MD
	2650 Ridge Ave., Dept. Of Anesthesia, Evanston, IL 60201
	(847) 570-2760
	Not Available

Map and Direction

Physician's Profile

Full Name	Kyle Petty
Gender	Male
Speciality	Anesthesiology
Location	2650 Ridge Ave., Evanston, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104310630
Provider Enumeration Date: 06/18/2018
Last Update Date: 12/28/2022

Medicare PECOS Information:

PECOS PAC ID: 3274880224
Enrollment ID: I20230105002868

Medical Identifiers

Medical identifiers for Kyle Petty such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104310630	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207L00000X	Anesthesiology	036159935 (Illinois)	Primary
207L00000X	Anesthesiology	125.072135 (Illinois)	Secondary

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 Petty allows following entities to bill medicare on his behalf.

Entity Name	Northshore University Healthsystem Faculty Practice Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118

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 Petty 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
Kyle Petty, MD 2650 Ridge Ave., Dept. Of Anesthesiology, Evanston, IL 60201 Ph: (847) 570-2760	Kyle Petty, MD 2650 Ridge Ave., Dept. Of Anesthesia, Evanston, IL 60201 Ph: (847) 570-2760

Reviews and Comments

Anesthesiology Doctors in Evanston, IL

Luke S Janik, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Northshore University Health System; Dept Anesthesia, Evanston, IL 60201 Phone: 847-570-2000
Dr. Joseph Devin Roberts, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 216-276-3721
Dr. Kenneth Justin Naylor, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2700
Bernard Wittels, M.D., PH.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 355 Ridge Ave, Evanston, IL 60202 Phone: 847-316-6370
Richard Gelfand, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2650 Ridge Ave, Evanston Hospital, Evanston, IL 60201 Phone: 847-570-1206 Fax: 847-570-1248
Mark A Deshur, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston Hospital, Evanston, IL 60201 Phone: 847-570-1206 Fax: 847-570-1248

Kyle Petty, MD - Medicare Anesthesiology in Evanston, IL