Kerbi Dawn Elsenbroek, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

12469 Timberland Blvd # 501
Fort Worth, TX 76244-6548

Phone

(817) 431-6555

Fax

(817) 431-7979

NPI assigned

Mar 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.97 of 100Reported as group

Quality

76.91

Promoting interoperability

91

Improvement activities

40

Cost

77.16

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263
  Medicare reassignment Care Compare group
• R Todd Plott MD PA

  dba Dermatology Alliance - Keller

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1134426794
  NPD (past)

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1801119771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 IRISH DR",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761805741",
            "telephone_number": "817-800-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12469 TIMBERLAND BLVD # 501",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446548",
            "telephone_number": "817-431-6555",
            "fax_number": "817-431-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSENBROEK",
        "first_name": "KERBI",
        "middle_name": "DAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Elofson, M.D.
• Elsa Dental and Orthodontics, PLLC
• Marwa Elsaad
• Bachar Elsaadi, MD
• Alicia Marie Elsea, RN
• Mona Eltiar, APRN, FNP
• Cassandra Elvira, MS, RDN, LD
• Emason Incorporated (Doctors Pharmacy)
• Emcare DFW Emergency Physicians PLLC
• Emcc Chisholm Trail Physicians PLLC

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.