Individual provider Active NPI

Kenneth Earl Wright, PAC

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1043328834
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15893 Issued in TX
Practice address
2611 N Main Ave
San Antonio, TX 78212-2920
Phone
(210) 225-2769
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15893 TX Primary

Addresses

Primary practice location

2611 N Main Ave
San Antonio, TX 78212-2920

Mailing address

2611 N Main Ave
San Antonio, TX 78212-2920

Other practice location 1

309 Silverado
LA Vernia, TX 78121-4948
Phone (210) 335-2769

Other practice location 2

519 N King St Ste 103
Seguin, TX 78155-4859
Phone (210) 225-2769

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
I20240410003335 TX Practitioner - Physician Assistant 2264571934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ross DermatologyGroup PAC ID 1658852298, 5 clinicians

Practice addresses (Care Compare)

519 N King St
Suite 103
Seguin, TX 78155-4859
Phone (210) 225-2769

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
65.08 of 100Reported as group
Quality
61.49
Improvement activities
20
Cost
84.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1163COMDOptometrist
PA15893TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ross Dermatology CurrentSince Dec 23, 2025 Accepting new patients

Locations

309 Silverado
Lavernia, TX 78121
Phone (210) 225-2769

2611 N Main Ave
San Antonio, TX 78212
Phone (210) 225-2769

1303 McCullough Ave
Ste 560
San Antonio, TX 78212
Phone (210) 223-9617

519 N King St
Ste 103
Seguin, TX 78155
Phone (210) 225-2769

Interoperability endpoints

  • Direct secure messaging: kenneth.wright@3259.securemail.prognocis.com

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1043328834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 N MAIN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 N MAIN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122920",
            "telephone_number": "210-225-2769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Silverado",
            "address_purpose": "LOCATION",
            "city": "LA Vernia",
            "state": "TX",
            "postal_code": "781214948",
            "country_code": "US",
            "telephone_number": "210-335-2769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "519 N King St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Seguin",
            "state": "TX",
            "postal_code": "781554859",
            "country_code": "US",
            "telephone_number": "210-225-2769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KENNETH",
        "middle_name": "EARL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.