Kristen Nicole McCorquodale, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12853 Issued in TX

Practice address

3320 Oakwell CT
San Antonio, TX 78218-3128

Phone

(210) 829-5180

Fax

(210) 829-5030

NPI assigned

Jul 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.89 of 100Reported as apm

Quality

78.84

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kristen@txdermandlaser.emadirect.md

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.

• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  TX

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1104479104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OAKWELL CT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183128",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OAKWELL CT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183128",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1763 Medical Way Ste B",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781325415",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8019 S New Braunfels Ste 120",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782351069",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3349 S Highway 181 Ste 13A",
            "address_purpose": "LOCATION",
            "city": "Kenedy",
            "state": "TX",
            "postal_code": "781195247",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21727 Ih 10 W Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782572107",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Schertz Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Schertz",
            "state": "TX",
            "postal_code": "781541457",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3326 Oakwell Court",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78218",
            "country_code": "US",
            "telephone_number": "210-829-5180",
            "fax_number": "210-829-5030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORQUODALE",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA12853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dauvon Lamar McCormick, CCP
• Elena Hope Perkins McCormick, M.S., CCC-SLP
• Sekinat K. McCormick, MD
• Shelby McCormick, LCSW
• Zachary McCormick
• Molly McCowan, RN
• Brittany McCoy, PHARMD
• Cody McCoy, ATC LAT
• Holly McCoy
• James Allen McCoy, CRT

• Medical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.

Verify at the official NPI Registry.