MRS. KELLY ANN GULLY (PA-C) – Physician Assistant, NPI 1063659878
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for MRS. KELLY ANN GULLY (PA-C)
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 752844658
Phone:
Type: Mailing
Scott & White Drive, College Station, Brazos County, Texas, 77845, United States
COLLEGE STATION, TX 778456440
Phone: (979) 207-4000
Fax: (979) 207-4562
Type: Location
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: 2009-04-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090427000121 | I | Physician Assistant | TX | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 73630 | X-ray of foot, minimum of 3 views | 77 | 40 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 41 | 34 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 37 | 23 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 36 | 23 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 34 | 30 | $0 |
Insurance plans in this area (ZIP 75284)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | TX | |
| Hand Surgery | ND | |
| - | TX | |
| General Surgery | TX | |
| Orthopedic Surgery, Sports Medicine | TX | |
| Pediatric Medicine | TX | |
| Family Practice | TX | |
| Family Practice | TX | |
| Family Practice, Emergency Medicine, General Practice, Physical Medicine And Rehabilitation | TX | |
| Physical Therapist In Private Practice | CT |
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