Keith Pensom, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K9387 Issued in TX

Practice address

544 W Seminary Dr
Fort Worth, TX 76115-1360

Phone

(817) 924-7978

NPI assigned

Jun 13, 2007

Last updated

Aug 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as virtual group

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Elite Hospital Partners, PLLC

  • Emergency Medicine Physician
  • Allen, TX
  • NPI 1609625995
  Medicare reassignment NPD
• Emergency Services of Texas PA

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1174932131
  Medicare reassignment NPD
• Ess of South Texas LLC

  • Emergency Medicine Physician
  • Liberty, TX
  • NPI 1295128247
  Medicare reassignment NPD
• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1649669672
  Medicare reassignment NPD
• Port Arthur Emergency Physicians

  • Emergency Medicine Physician
  • Port Arthur, TX
  • NPI 1255491627
  Medicare reassignment NPD
• Small Hospital Innovations LLC

  • Emergency Medicine Physician
  • Clewiston, FL
  • NPI 1184040560

  TX

  Medicare reassignment NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment
• Euless Health Care Corp

  • Health Service Clinic/Center
  • Hurst, TX
  • NPI 1770819559
  NPD (past)
• Texas Em-1 Medical Services PA

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1659446193
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1689878761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 W SEMINARY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151360",
            "telephone_number": "817-924-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 W SEMINARY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151360",
            "telephone_number": "817-924-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENSOM",
        "first_name": "KEITH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K9387",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K9387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Amber Pennington
• Pennsylvania Rehab LP
• Richard E. Penny, M.D.
• Karen Ann Penrod, LPC
• Emily Penrose, COTA
• Shanelle Laniece Peoples-Lambert
• Desiree Peoples, LCSW
• Eric William Pepin, MD PHD
• Annalisa Peppard, MS, CCC-SLP
• Kraig Robert Pepper, DO PA

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.