DR. KYLE DEERWESTER MD
NPI 1134624018
Pediatrics - Pediatric Critical Care Medicine in Brockton, MA

Q: What is Kyle Deerwester's NPI number?

The NPI number for Kyle Deerwester is 1134624018. It was assigned to this individual provider in the NPPES registry on March 24, 2018.

Q: What is Kyle Deerwester's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Deerwester was last updated on April 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 24, 2018PECOS Enrolled

680 CENTRE ST, BROCKTON, MA 02302(508) 941-7580(508) 941-6268 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 10, 2026, Mar 21, 2025, May 6, 2022 and 1 more (4 updates tracked since 2018).

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About Dr. Kyle Deerwester Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KYLE DEERWESTER MD (NPI 1134624018) is an individual pediatric critical care medicine provider in Brockton, Massachusetts, licensed in Massachusetts (1019638) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1134624018

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameDR. KYLE DEERWESTERCredential: MD

Location Address680 CENTRE STBrockton, MA 02302-3308

Mailing Address680 Centre StBrockton, MA 02302-3308 · (508) 941-7580 · Fax (508) 941-6268

Phone(508) 941-7580

Fax(508) 941-6268

Sole ProprietorNo

Enumeration DateMarch 24, 2018

Last NPPES UpdateApril 10, 20264 updates tracked since enumeration

NPPES CertifiedApril 10, 2026

✔ NPI 1134624018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

Licenses✔ Licensed in MA · 1019638✔ Licensed in IL · 036.159618

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License MD21241 (RI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

680 CENTRE ST, Brockton, MA 02302

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Secondary Practice Locations 2

Location 15841 S Maryland Ave # Mc1145Chicago, IL 60637-1443 · Phone (773) 702-3020 · Fax (773) 702-4041

Location 21085 N Main StProvidence, RI 02904-5719 · Phone (401) 415-4200

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kyle Deerwester Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.