Individual provider Active NPI

Kevin Joseph Records, MD

  • Surgical Critical Care Physician
  • Tyler, TX
National Provider Identifier
1235660085
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
U6557 Issued in TX
Practice address
1020 E Idel St
Tyler, TX 75701-2024
Phone
(903) 535-2902
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X U6557 TX
Surgical Critical Care Physician 2086S0102X U6557 TX Primary
Trauma Surgery Physician 2086S0127X U6557 TX

Addresses

Primary practice location

1020 E Idel St
Tyler, TX 75701-2024

Mailing address

1020 E Idel St
Tyler, TX 75701-2024
Phone (903) 535-2902

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920002731 TX Practitioner - General SurgeryPractitioner - Other (Physician) 4486910478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1020 E Idel St
Tyler, TX 75701-2024
Phone (903) 535-2902

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2023 Accepting new patients
Tyler Regional Hospital LLC Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1020 E Idel St
Tyler, TX 75701
Phone (903) 535-2902

Interoperability endpoints

  • Direct secure messaging: krecords886630@ahs.direct-ci.com

Organizations & group practices 3

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 3

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1235660085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E IDEL ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012024",
            "telephone_number": "903-535-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E IDEL ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012024",
            "telephone_number": "903-535-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECORDS",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "U6557",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "U6557",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "U6557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.