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DR. KYLE RICHARD CARLSON D.O.
NPI 1255718367
Orthopaedic Surgery in Warsaw, IN

Active since April 28, 2015PECOS EnrolledAccepts Medicare Assignment
1500 PROVIDENT DR STE B, WARSAW, IN 46580(260) 484-8551(260) 482-5060 Get Directions Write a Review

NPPES record last updated: December 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 10, 2024, Feb 5, 2024, May 3, 2023 and 2 more (5 updates tracked since 2021).

About Dr. Kyle Richard Carlson D.o. NPPES

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

DR. KYLE RICHARD CARLSON D.O. (NPI 1255718367) is an individual orthopaedic surgery provider in Warsaw, Indiana, licensed in Indiana (02006490A) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Goshen Hospital, and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2015).

NPPES Registry Identity

NPI1255718367
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. KYLE RICHARD CARLSONCredential: D.O.
Location Address1500 PROVIDENT DR STE BWarsaw, IN 46580-3297
Mailing Address5052 N Clinton StFort Wayne, IN 46825-5822 · (260) 408-2203 · Fax (260) 408-8014
Phone(260) 484-8551
Fax(260) 482-5060
Sole ProprietorYes
Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2015
Enumeration DateApril 28, 2015
Last NPPES UpdateDecember 10, 20245 updates tracked since enumeration
NPPES CertifiedDecember 10, 2024
✔ NPI 1255718367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in IN · 02006490A
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1500 PROVIDENT DR STE B, Warsaw, IN 46580
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Other Identifiers 1

Medicaid300052895IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kyle Richard Carlson D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103139712
PECOS Enrollment IDI20210723001788
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
43 services32 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
28 services28 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Goshen Hospital

Acute Care Hospitals · Goshen, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150026
Location200 High Park AveGoshen, IN 46526 · Elkhart County
Emergency services Birthing friendly

Parkview Whitley Hospital

Acute Care Hospitals · Columbia City, IN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150101
Location1260 E Sr 205Columbia City, IN 46725 · Whitley County
Emergency services Birthing friendly

Kosciusko Community Hospital

Acute Care Hospitals · Warsaw, IN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number150133
Location2101 E Dubois DrWarsaw, IN 46580 · Kosciusko County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46580 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAMON D WILLIAMS MD
Orthopaedic Surgery
1500 PROVIDENT DR STE B
WARSAW, IN 46580
Kosciusko County (574) 269-8301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Carlson's NPI number?

The NPI number for Kyle Carlson is 1255718367. It was assigned to this individual provider in the NPPES registry on April 28, 2015.

Where is Kyle Carlson located?

Kyle Carlson practices at 1500 Provident Dr Ste B, Warsaw, IN 46580. The listed phone number is (260) 484-8551.

What is Kyle Carlson's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Kyle Carlson enrolled in Medicare?

Yes. Kyle Carlson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kyle Carlson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Kyle Carlson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kyle Carlson affiliated with any hospitals?

According to CMS data, Kyle Carlson is affiliated with Goshen Hospital, Parkview Whitley Hospital and Kosciusko Community Hospital.

When was this NPI record last updated?

The NPPES record for Kyle Carlson was last updated on December 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.