KENNETH DEAN ARCHER (MD) – Family Medicine Physician, NPI 1083654123

KENNETH DEAN ARCHER (MD) is a healthcare provider. based in Fort worth, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. L7965 (TX). The NPI Number for KENNETH DEAN ARCHER (MD) is 1083654123

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH DEAN ARCHER (MD)
NPI
1083654123
Phone
(817) 691-8711
Address
5751 KROGER DR STE 113
Enumeration Date
7 June 2006
Last Update Date
20 October 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Secondary Phone
9034553500
Graduation Year
2002 (24 years ago)
PAC ID
6800897075
Group Practice PAC ID
0749583128
Professional Enrollment ID
I20070131000227
Address ID
TX754026364GR5005XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

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Provider Addresses for KENNETH DEAN ARCHER (MD)

  • 5751 KROGER DR STE 113

    FORT WORTH, TX 762445633

    Phone: (817) 691-8711

    Type: Mailing

  • 140, North Beach Street, Fort Worth, Tarrant County, Texas, 76111, United States

    FORT WORTH, TX 76137

    Phone: (817) 281-2977

    Fax: (817) 788-2530

    Type: Location

  • 2000 S FM 51

    DECATUR, TX 762343702

    Phone: (817) 479-3818

    Fax: (817) 479-3884

    Type: Mailing

  • 8479 DAVIS BLVD STE 300

    NORTH RICHLAND HILLS, TX 761828604

    Phone: (817) 479-3818

    Fax: (817) 479-3884

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $476.

Total Amount is formed as General ($476) + Research ($0) + Ownership ($0) = $476.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($145).

Total Amount

$476

General + Research + Ownership

Payments

20

Total payment records

General Amount

$476

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2007-01-31

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
I20070131000227IFamily PracticeTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes482203$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes397143$0
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes224215$0
99214Established patient office or other outpatient visit, 30-39 minutes1613$0
99316Nursing facility discharge management, more than 30 minutes1312$0
View full utilization report →

Insurance plans in this area (ZIP 76244)

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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: 0749583128View full group profile
NameSpecialtyState
-TX

Reviews

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Frequently asked questions

What number should I use to identify KENNETH DEAN ARCHER (MD) for billing?
Administrative and clinical systems typically use NPI 1083654123 for KENNETH DEAN ARCHER (MD).
Is KENNETH DEAN ARCHER (MD)'s NPI status active today?
Active status means KENNETH DEAN ARCHER (MD)'s NPI record is not deactivated in the public file.
What does the directory say KENNETH DEAN ARCHER (MD) does?
Insurance directories may phrase it differently, but here KENNETH DEAN ARCHER (MD) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is KENNETH DEAN ARCHER (MD) tied to Fort Worth, Texas?
If you are local to Fort Worth, Texas, KENNETH DEAN ARCHER (MD) may be relevant to your search.
Can I export KENNETH DEAN ARCHER (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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