Kyle Petrey, DPT is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Fort Sam Houston, Texas. His current practice location is
3551 Roger Brooke Dr, Fort Sam Houston, Texas. You can reach out to his office (for appointments etc.) via phone at
(847) 274-2794.
Kyle Petrey is licensed to practice in Illinois (license number 070020914) 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 1235547621.
Healthcare Provider's Profile
Full Name | Kyle Petrey |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3551 Roger Brooke Dr, Fort Sam Houston, Texas |
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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: 1235547621
- Provider Enumeration Date: 07/29/2014
- Last Update Date: 08/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 5799906566
- Enrollment ID: I20220710000107
Medical Identifiers
Medical identifiers for Kyle Petrey such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235547621 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 070020914 (Illinois) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 070020914 (Illinois) | Primary |
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 Petrey 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 Petrey, DPT 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 Ph: (847) 274-2794 | Kyle Petrey, DPT 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 Ph: (847) 274-2794 |
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