Individual provider Active NPI

Kevin L Stewart, M.D.

  • Family Medicine Physician
  • Garland, TX
National Provider Identifier
1679578660
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H5806 Issued in TX
Practice address
305 River Fern Ave Apt 1425
Garland, TX 75040-2404
Phone
(806) 224-3369
NPI assigned
Jun 16, 2005
Reactivated
Mar 29, 2006
Last updated
May 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H5806 TX Primary

Addresses

Primary practice location

305 River Fern Ave Apt 1425
Garland, TX 75040-2404

Mailing address

305 River Fern
Apt 1425
Garland, TX 75040
Phone (806) 224-3369

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
I20081024000500 TX Practitioner - Family Practice 5294893913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1700 Murchison Dr
Suite 211
El Paso, TX 79902-2918
Phone (915) 533-5100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Disease Care of El Paso, PLLC CurrentSince Sep 12, 2017 Accepting new patients
Midland Emergency Management PLLC Past Accepting new patients

Locations

1700 Murchison Dr
Ste 211
El Paso, TX 79902
Phone (915) 533-5100

2400 Trawood Dr
Ste 202
El Paso, TX 79936
Phone (915) 533-5100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1679578660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 RIVER FERN",
            "address_2": "APT 1425",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75040",
            "telephone_number": "806-224-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 RIVER FERN AVE APT 1425",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402404",
            "telephone_number": "806-224-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2017-05-25",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H5806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.