Individual provider Active NPI

Kaylae Wisner Weishaar, DO

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1629761770
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V9996 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 877-7200
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V9996 TX Primary
Emergency Medicine Physician 207P00000X V9996 TX

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

11937 US Highway 271
Tyler, TX 75708-3154

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
I20260206001262 TX Practitioner - Family Practice 6608237607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ess of Crockett, LLCGroup PAC ID 3678942778, 21 clinicians

Practice addresses (Care Compare)

1100 E Loop
Suite 304
Crockett, TX 75835-1810
Phone (936) 931-3891

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V9996TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ess of South Texas LLC Emergency Medicine CurrentSince Mar 1, 2026 Accepting new patients
Inpatient Physician Associates PLLC CurrentSince Feb 15, 2026 Accepting new patients

Locations

6901 Snider Plz
Ste 130
Dallas, TX 75205
Phone (972) 381-6690

1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316

3150 Horizon Rd
Rockwall, TX 75032
Phone (469) 697-1000

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

Interoperability endpoints

  • Direct secure messaging: kweishaar876842@ahs.direct-ci.com

Organizations & group practices 4

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 4

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1629761770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISHAAR",
        "first_name": "KAYLAE",
        "middle_name": "WISNER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V9996",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V9996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.