Individual provider Active NPI

Kevin Reese, NP

  • Gerontology Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1174190979
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP111111 Issued in TX
Practice address
4835 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75244-6001
Phone
(469) 420-5544
NPI assigned
Jun 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP111111 TX Primary

Addresses

Primary practice location

4835 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75244-6001

Mailing address

PO Box 392571
Pittsburgh, PA 15251-9571
Phone (469) 420-5544

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
I20210811002871 TX Practitioner - Nurse Practitioner 6406250570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Critical Care PAGroup PAC ID 6103041637, 79 clinicians

Practice addresses (Care Compare)

2710 Swiss Ave
Dallas, TX 75204-5900
Phone (214) 821-2303

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.87 of 100Reported as group
Quality
90.89
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.41 of 100Reported as group
Quality
88.72
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP111111TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Surgery Associates, P.a. CurrentSince Jan 8, 2022 Accepting new patients
North Texas Critical Care PA CurrentSince Sep 1, 2021 Accepting new patients

Locations

621 N Hall St
Dallas, TX 75226
Phone (214) 820-0600

2710 Swiss Ave
Dallas, TX 75204
Phone (214) 821-2303

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1174190979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392571",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519571",
            "telephone_number": "469-420-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 LYNDON B JOHNSON FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752446001",
            "telephone_number": "469-420-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "KEVIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP111111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.