Individual provider Active NPI

Kelsey Nicole Burkhart, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1003494485
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14557 Issued in TX
Practice address
1935 Medical District Dr
Dallas, TX 75235-7701
Phone
(214) 456-7000
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA14557 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-7000

Other names 1

  • Kelsey Nicole Edinger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210617002211 TX Practitioner - Physician Assistant 2668872276 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

6210 John Ryan Dr
Suite 107
Fort Worth, TX 76132-4111
Phone (817) 321-0404

800 W Magnolia Ave
Fort Worth, TX 76104-4611

801 7TH Ave
Fort Worth, TX 76104-2733
Phone (817) 321-0937

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas PA CurrentSince Mar 18, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 7, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 7, 2021 Accepting new patients

Locations

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

1622 8th Ave
Ste 120
Fort Worth, TX 76104
Phone (817) 923-8220

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

5425 W Spring Creek Pkwy
Plano, TX 75024
Phone (972) 599-9600

1814 Roseland Blvd
Ste 100
Tyler, TX 75701
Phone (214) 696-8033

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1003494485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "EDINGER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.