KYLE ROTHERHAM PA-C
NPI 1780397018
Physician Assistant - Surgical in Omaha, NE

Q: What is Kyle Rotherham's NPI number?

The NPI number for Kyle Rotherham is 1780397018. It was assigned to this individual provider in the NPPES registry on January 2, 2023.

Q: What is Kyle Rotherham's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Rotherham was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since January 02, 2023PECOS EnrolledAccepts Medicare Assignment

8005 FARNAM DR STE 305, OMAHA, NE 68114(402) 390-4111(402) 390-4115 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 15, 2023, Oct 30, 2023, Jan 24, 2023 and 2 more (5 updates tracked since 2023).

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About Kyle Rotherham Pa-c NPPES

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

KYLE ROTHERHAM PA-C (NPI 1780397018) is an individual surgical provider in Omaha, Nebraska, licensed in Nebraska (2867) and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS, is affiliated with The Nebraska Methodist Hospital, and is a graduate of Creighton University School Of Medicine (2022).

NPPES Registry Identity

NPI1780397018

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameKYLE ROTHERHAMCredential: PA-C

Location Address8005 FARNAM DR STE 305Omaha, NE 68114-3426

Mailing Address8005 Farnam Dr Ste 305Omaha, NE 68114-3426 · (402) 390-4111 · Fax (402) 390-4115

Phone(402) 390-4111

Fax(402) 390-4115

Sole ProprietorNo

Medical School CMSCreighton University School Of MedicineGraduated 2022

Enumeration DateJanuary 2, 2023

Last NPPES UpdateOctober 30, 20255 updates tracked since enumeration

NPPES CertifiedOctober 30, 2025

✔ NPI 1780397018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in NE · 2867

Also ListedPhysician AssistantTaxonomy 363A00000X · License 1204103 (NE), 2867 (NE), 118173 (IA)

8005 FARNAM DR STE 305, Omaha, NE 68114

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, 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

Kyle Rotherham 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 ID3072984285

PECOS Enrollment IDI20230126002348

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 17

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

604 services62 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.

92 services87 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

86 services34 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

66 services57 patients

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.

61 services58 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

31 services31 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.

29 services29 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

27 services27 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

26 services26 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

24 services23 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

22 services22 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.

22 services22 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

19 services15 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

17 services17 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

15 services15 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

13 services13 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

The Nebraska Methodist Hospital

Acute Care Hospitals · Omaha, NE

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280040

Location8303 Dodge StOmaha, NE 68114 · Douglas County

Emergency services Birthing friendly

Midwest Surgical Hospital LLC

Acute Care Hospitals · Omaha, NE

OwnershipPhysician

CMS Certification Number280131

Location7915 Farnam DriveOmaha, NE 68114 · Douglas County

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.

SAMUEL P PHILLIPS M.D.

Orthopaedic Surgery