KYLE LEE SCARBOROUGH MD
NPI 1417045303
Family Medicine in Conroe, TX

Q: What is Kyle Scarborough's NPI number?

The NPI number for Kyle Scarborough is 1417045303. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Q: What is Kyle Scarborough's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Scarborough was last updated on March 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 10, 2006PECOS EnrolledAccepts Medicare Assignment

76.37/100

CMS Quality Rating

603 S. CONROE MEDICAL CENTER BLVD, STE 110, CONROE, TX 77304(936) 760-9900(936) 760-9926 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Kyle Lee Scarborough Md NPPES

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

KYLE LEE SCARBOROUGH MD (NPI 1417045303) is an individual family medicine provider in Conroe, Texas, licensed in Texas (H8380) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Houston Healthcare Conroe, and is a graduate of University Of Texas Medical School At Houston (1989).

NPPES Registry Identity

NPI1417045303

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameKYLE LEE SCARBOROUGHCredential: MD

Location Address603 S. CONROE MEDICAL CENTER BLVD, STE 110Conroe, TX 77304

Mailing Address603 S Conroe Medical Dr Ste 110Conroe, TX 77304-5395 · (936) 760-9900 · Fax (936) 760-9926

Phone(936) 760-9900

Fax(936) 760-9926

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 1989

Enumeration DateOctober 10, 2006

Last NPPES UpdateMarch 23, 2023

NPPES CertifiedMarch 22, 2023

✔ NPI 1417045303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · H8380

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

603 S. CONROE MEDICAL CENTER BLVD, Conroe, TX 77304

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Other Identifiers 1

Medicaid118743702TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.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

Kyle Lee Scarborough Md 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 ID3870688617

PECOS Enrollment IDI20110107000984

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 23

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,783 services753 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

503 services103 patients

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.

481 services351 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

393 services393 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

349 services206 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

259 services252 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

241 services184 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

199 services137 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

186 services123 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

182 services86 patients

Injection, methylprednisolone acetate, 20 mg J1020

Methylprednisolone acetate is a medication given via injection to reduce inflammation and pain. It's often used to treat conditions like arthritis, allergic reactions, and certain skin diseases. The 20 mg dose is tailored to your specific needs.

131 services57 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

111 services101 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.

41 services41 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

39 services37 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

36 services35 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

26 services26 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

22 services22 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

21 services20 patients

Removal of impacted ear wax by washing 69209

Impacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.

18 services18 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

17 services16 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

15 services14 patients

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report G0403

An Electrocardiogram (ECG) with 12 leads is a non-invasive test that measures the electrical activity of your heart. It's performed during your initial physical examination to screen for heart conditions. The results are interpreted and compiled into a report for further evaluation.

14 services14 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Hca Houston Healthcare Conroe

Acute Care Hospitals · Conroe, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450222

Location504 Medical Center BlvdConroe, TX 77304 · Montgomery County

Emergency services Birthing friendly

Tops Surgical Specialty Hospital

Acute Care Hospitals · Houston, TX

OwnershipPhysician

CMS Certification Number450774

Location17080 Red Oak DriveHouston, TX 77090 · Harris County

Hca Houston Healthcare Kingwood

Acute Care Hospitals · Kingwood, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450775

Location22999 Us Hwy 59Kingwood, TX 77325 · Harris County

Emergency services Birthing friendly

Aspire Hospital

Acute Care Hospitals · Conroe, TX

OwnershipPhysician

CMS Certification Number670093

Location2006 South Loop 336 West, Suite 500Conroe, TX 77304 · Montgomery County

Houston Methodist The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670122

Location17201 Interstate 45 SouthThe Woodlands, TX 77385 · Montgomery County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77304 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.37/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

21.23

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

22%671 patients1/55-star benchmark: 96%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

98%1,337 patients4/55-star benchmark: 100%

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation

Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented

15%122 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

32%1,563 patients2/55-star benchmark: 99%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

17%307 patients1/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%5,530 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

87%3,612 patients4/55-star benchmark: 100%

Falls: Plan of Care

Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months

98%84 patients4/55-star benchmark: 100%

Falls: Risk Assessment

Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months

99%84 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

9%1,092 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

37%1,331 patients2/55-star benchmark: 95%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%645 patients4/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

100%1,092 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

76%1,092 patients4/55-star benchmark: 77%

Send a Summary of Care

For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…

33%480 patients2/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

20 suppliers84 claims231 services$5.96 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

11 suppliers25 claims34 services$1.13 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

6 suppliers17 claims17 services$30.55 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

5 suppliers14 claims79 services$13.92 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers16 claims16 services$42.51 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

6 suppliers11 claims11 services$15.23 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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 Scarborough's NPI number?

The NPI number for Kyle Scarborough is 1417045303. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Kyle Scarborough located?

Kyle Scarborough practices at 603 S. Conroe Medical Center Blvd Ste 110, Conroe, TX 77304. The listed phone number is (936) 760-9900.

What is Kyle Scarborough's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kyle Scarborough enrolled in Medicare?

Yes. Kyle Scarborough 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 Scarborough accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Kyle Scarborough 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 Scarborough affiliated with any hospitals?

According to CMS data, Kyle Scarborough is affiliated with Hca Houston Healthcare Conroe, Tops Surgical Specialty Hospital, Hca Houston Healthcare Kingwood, Aspire Hospital and Houston Methodist The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Kyle Scarborough was last updated on March 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.