Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle Nielsen, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1205490372

Kyle Nielsen, DO is an Emergency Medicine in Port St Lucie, Florida. Qualified in 2020, 6 years ago. Practices with Paragon Contracting Services LLC, a 395-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
6
Licensed in
FL
In the registry since
2019
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone: (623) 556-3784
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence OS19626 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1205490372
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 24, 2019
Last updated in NPPESJune 1, 2023
Certification dateJune 1, 2023
Mailing address13657 W Remuda Dr, Peoria, AZ 85383-8306

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Paragon Contracting Services Llc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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