Kelly Peters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08226 Issued in TX

Practice address

4031 W Plano Pkwy
Suite 100
Plano, TX 75093-5619

Phone

(972) 985-1072

Fax

(972) 596-9382

NPI assigned

May 21, 2013

Sex

Female

Sole proprietor

Yes

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

Merit-based Incentive Payment System (MIPS)

Final score

89.4 of 100Reported as group

Quality

77.91

Promoting interoperability

100

Improvement activities

40

Cost

86.76

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• American Pain & Wellness PA

  • Pain Medicine (Anesthesiology) Physician
  • Allen, TX
  • NPI 1306857305
  Medicare reassignment
• Texas Health Back Care

  dba Spine Team Texas

  • Physical Medicine & Rehabilitation Physician
  • Rockwall, TX
  • NPI 1811366982
  Medicare reassignment
• American Pain & Wellness PA

  • Pain Medicine (Anesthesiology) Physician
  • Colleyville, TX
  • NPI 1376205864
  NPD
• Texas Health Back Care

  dba Spine Team Texas

  • Physical Medicine & Rehabilitation Physician
  • Southlake, TX
  • NPI 1770952830
  NPD

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1144666793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935619",
            "telephone_number": "972-985-1072",
            "fax_number": "972-596-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935619",
            "telephone_number": "972-985-1072",
            "fax_number": "972-596-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter N. Schochet, M.D., P.a.
• Peter R. Barnett, DMD, P.a. (Star Ranch Dental Spa)
• Mark A Peterman, MD
• Kaitlin Peters, LPC
• Kari Peters, LPC
• Petersen Anesthesia Services
• Matthew Leif Peterson, LPC
• Myranda Peterson, BCBA
• James Joseph Petrikas Sr., DO
• Trent Leon Pettijohn, MD

• Physician Assistant in Plano, TX
• Providers in Plano, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.