Active NPI
David Brent Kerns, MD
- Vascular Surgery Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- K0862
- Practice address
- 1040 S Fleishel Ave
Tyler, TX 75701-2031 - Phone
- (903) 533-8702
- Fax
- (903) 533-8720
- NPI assigned
- Aug 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | K0862 | TX | |
| Vascular Surgery Physician | 2086S0129X | K0862 | TX | Primary |
Addresses
Primary practice location
1040 S Fleishel Ave
Tyler, TX 75701-2031
Mailing address
1040 S Fleishel Ave
Tyler, TX 75701-2031
Phone (903) 533-8702
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770001111 | Other | TX | RAILROAD MEDICARE |
| MDK0862 | Other | TX | TEXAS WORKERS COMP / IHC |
| 045355701 | Medicaid | TX | |
| 3292271 | Other | TX | BLUELINK |
| 5849465 | Other | TX | AETNA |
| 86Z401 | Other | TX | BCBS TX |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Texas Southwestern Medical School at Dallas, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611
Hospital & facility affiliations
- Enhabit Home Health
- Enhabit Home Health
- Ut Health East Texas Tyler Regional Hospital
- University of Texas Health Science Center at Tyler
- Ut Health East Texas Athens Hospital
- Christus Mother Frances Hospital
- Christus Good Shepherd Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 41 |
| Leg revascularization (restoring blood flow) | 41 |
| Removal of tissue | 17 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K0862 | TX | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Robbins MD PA | Surgery | Current | Accepting new patients |
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| East Texas Medical Center | Past | Accepting new patients |
Locations
18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292
1002 N Mound St
Nacogdoches, TX 75961
Phone (936) 560-3800
1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068
6210 S Broadway Ave
Tyler, TX 75703
Phone (903) 579-2700
1040 S Fleishel Ave
Tyler, TX 75701
Phone (903) 533-8702
2401 Sse Loop 323
Tyler, TX 75701
Phone (903) 510-7212
700 Olympic Plaza Cir
Ste 510
Tyler, TX 75701
Phone (903) 595-2636
Organizations & group practices 4
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.
-
- Cardiovascular Disease Physician
- Tyler, TX
- NPI 1609382662
-
- Surgery Physician
- Tyler, TX
- NPI 1245456375
-
- Rural Health Clinic/Center
- Chandler, TX
- NPI 1235706581
-
- Land Ambulance
- Bellmead, TX
- NPI 1568964518
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Tyler, TX
- NPI 1588644934
-
- Home Health Agency
- Longview, TX
- NPI 1609934470
-
- General Acute Care Hospital
- Athens, TX
- NPI 1417465824
-
- General Acute Care Hospital
- Longview, TX
- NPI 1124092036
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1407364847
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1417941295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1073515565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 S FLEISHEL AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757012031",
"telephone_number": "903-533-8702",
"fax_number": "903-533-8720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 S FLEISHEL AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757012031",
"telephone_number": "903-533-8702",
"fax_number": "903-533-8720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNS",
"first_name": "DAVID",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "K0862",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "TX",
"license": "K0862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "770001111",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS WORKERS COMP / IHC",
"identifier": "MDK0862",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "045355701",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUELINK",
"identifier": "3292271",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5849465",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TX",
"identifier": "86Z401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.