Kyle Woodson, MD is a medicare enrolled "Pediatrics" physician in Wagoner, Oklahoma. His current practice location is
1202 W Cherokee St Ste A, Wagoner, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(918) 485-1303.
Kyle Woodson is licensed to practice in Oklahoma (license number 29254) 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 1720349426.
Physician's Profile
Full Name | Kyle Woodson |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 1202 W Cherokee St Ste A, Wagoner, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1720349426
- Provider Enumeration Date: 05/30/2012
- Last Update Date: 04/01/2022
Medicare PECOS Information:
- PECOS PAC ID: 1355631052
- Enrollment ID: I20160609000118
Medical Identifiers
Medical identifiers for Kyle Woodson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720349426 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 29254 (Oklahoma) | 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 Woodson allows following entities to bill medicare on his behalf.
Entity Name | Board Of Regents Of The University Of Oklahoma - Ou Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1801869250 PECOS PAC ID: 2860304334 Enrollment ID: O20031103000607 |
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Entity Name | Wagoner Hospital Authority |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1386611580 PECOS PAC ID: 0042217531 Enrollment ID: O20061214000095 |
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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 Woodson 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 Woodson, MD 1200 W Cherokee St, Wagoner, OK 74467-4624 Ph: (918) 485-5514 | Kyle Woodson, MD 1202 W Cherokee St Ste A, Wagoner, OK 74467-4629 Ph: (918) 485-1303 |
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