MR. KYLE VIVO PA-C
NPI 1407982689
Physician Assistant - Medical in Los Angeles, CA

Active since February 24, 2007PECOS EnrolledAccepts Medicare Assignment
311 WINSTON ST, LOS ANGELES, CA 90013(213) 893-1960 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Kyle Vivo Pa-c NPPES

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

MR. KYLE VIVO PA-C (NPI 1407982689) is an individual medical provider in Los Angeles, California, licensed in California (18774) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1407982689
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. KYLE VIVOCredential: PA-C
Location Address311 WINSTON STLos Angeles, CA 90013-1519
Mailing Address2126 Mozart StLos Angeles, CA 90031-2246 · (626) 674-8109
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateFebruary 24, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1407982689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · 18774
311 WINSTON ST, Los Angeles, CA 90013

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

Mr. Kyle Vivo Pa-c 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 ID1850498981
PECOS Enrollment IDI20070523000712
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.

Other Providers at the Same Location NPPES 20

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

Registered Nurse
311 WINSTON ST, LOS ANGELES MISSON COMMUNITY CLINIC
LOS ANGELES, CA 90013
Physician Assistant
311 WINSTON ST
LOS ANGELES, CA 90013
Physician Assistant
311 WINSTON ST
LOS ANGELES, CA 90013
Registered Nurse
311 WINSTON ST
LOS ANGELES, CA 90013
Psychologist
311 WINSTON ST
LOS ANGELES, CA 90013
Physician Assistant (Medical)
311 WINSTON ST
LOS ANGELES, CA 90013
Clinic/Center (Federally Qualified Health Center (FQHC))
311 WINSTON ST
LOS ANGELES, CA 90013
Physician Assistant
311 WINSTON ST
LOS ANGELES, CA 90013

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 Vivo's NPI number?

The NPI number for Kyle Vivo is 1407982689. It was assigned to this individual provider in the NPPES registry on February 24, 2007.

Where is Kyle Vivo located?

Kyle Vivo practices at 311 Winston St, Los Angeles, CA 90013. The listed phone number is (213) 893-1960.

What is Kyle Vivo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kyle Vivo enrolled in Medicare?

Yes. Kyle Vivo 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.

When was this NPI record last updated?

The NPPES record for Kyle Vivo was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.