Individual provider Active NPI

Kelly Brennan

  • Physician Assistant
  • Arlington, TX
National Provider Identifier
1376309039
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17677 Issued in TX
Practice address
3533 Matlock Rd
Arlington, TX 76015-3604
Phone
(817) 419-0303
Fax
(833) 626-1951
NPI assigned
Feb 21, 2024
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17677 TX Primary

Addresses

Primary practice location

3533 Matlock Rd
Arlington, TX 76015-3604

Mailing address

2535 Ira E Woods Ave
Grapevine, TX 76051-3930
Phone (817) 481-2121

Other practice location 1

76 Regency Pkwy
Mansfield, TX 76063-7816
Phone (817) 419-0303

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
I20240520001407 TX Practitioner - Physician Assistant 9032551221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Doctx3 PLLCGroup PAC ID 1355620055, 85 clinicians
Tmi Sports Medicine and Orthopedic Surgery PAGroup PAC ID 1052399508, 19 clinicians

Practice addresses (Care Compare)

3014 N O Connor Rd
200 Direct Orthopedic Care
Irving, TX 75062-4415
Phone (469) 648-2282

3533 Matlock Rd
Arlington, TX 76015-3604
Phone (817) 419-0303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17677TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctx3 PLLC CurrentSince Feb 26, 2025 Accepting new patients
Doctx3 PLLC CurrentSince Feb 26, 2025 Accepting new patients
Tmi Sports Medicine and Orthopedic Surgery PA CurrentSince Jun 6, 2025 Accepting new patients
Tmi Sports Medicine and Orthopedic Surgery PA CurrentSince Jun 6, 2025 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

3533 Matlock Rd
Arlington, TX 76015
Phone (817) 419-0303

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

76 Regency Pkwy
Mansfield, TX 76063
Phone (817) 419-0303

Interoperability endpoints

  • Direct secure messaging: kelly.brennan.1@20300.direct.athenahealth.com
  • Direct secure messaging: kelly.brennan.1@25955.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1376309039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513930",
            "telephone_number": "817-481-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153604",
            "telephone_number": "817-419-0303",
            "fax_number": "833-626-1951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Regency Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760637816",
            "country_code": "US",
            "telephone_number": "817-419-0303",
            "fax_number": "833-626-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.