KATHRYN MARIEL BREITHAUPT – Physician Assistant, NPI 1063280600

KATHRYN MARIEL BREITHAUPT is a healthcare provider. based in Richardson, Texas. specializing in PHYSICIAN ASSISTANT. The NPI Number for KATHRYN MARIEL BREITHAUPT is 1063280600

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN MARIEL BREITHAUPT
NPI
1063280600
Phone
(214) 453-4533
Address
2323 N CENTRAL EXPY
Enumeration Date
13 December 2023
Last Update Date
13 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2146037933
Graduation Year
2024 (2 years ago)
PAC ID
9436678026
Group Practice PAC ID
7618141433
Professional Enrollment ID
I20250528000178
Address ID
TX750938914PL3028XPKWY301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:2State licenses:0Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for KATHRYN MARIEL BREITHAUPT

  • 2323 N CENTRAL EXPY

    RICHARDSON, TX 750802712

    Phone: (214) 453-4533

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250528000178IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75080)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618141433View full group profile
NameSpecialtyState
-TX
Psychiatry, Geriatric PsychiatryTX
Nurse PractitionerKY
Physician AssistantTX
Physician AssistantTX

Reviews

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Frequently asked questions

Can I use this page to confirm KATHRYN MARIEL BREITHAUPT's NPI?
Yes. KATHRYN MARIEL BREITHAUPT is listed with NPI 1063280600 in the public NPI dataset.
Does the file indicate KATHRYN MARIEL BREITHAUPT is practicing under active NPI?
Directory data currently reports KATHRYN MARIEL BREITHAUPT as active.
What healthcare role does KATHRYN MARIEL BREITHAUPT hold?
Scheduling teams often label KATHRYN MARIEL BREITHAUPT under Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does KATHRYN MARIEL BREITHAUPT serve?
KATHRYN MARIEL BREITHAUPT's listing highlights Richardson, Texas; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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