ROBERT E EDMONSON (MD) – Cardiovascular Disease Physician, NPI 1124062005

ROBERT E EDMONSON (MD) is a healthcare provider. based in Dallas, Texas. specializing in Cardiovascular Disease Physician. They hold the professional credentials MD. They hold a License No. D0861 (TX). The NPI Number for ROBERT E EDMONSON (MD) is 1124062005

Main info

Male
63 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT E EDMONSON (MD)
NPI
1124062005
Phone
(214) 946-5165
Address
221 W COLORADO BLVD
Enumeration Date
15 June 2006
Last Update Date
18 September 2014

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
4695132666
Graduation Year
1963 (63 years ago)
PAC ID
7911047329
Group Practice PAC ID
5597046672
Professional Enrollment ID
I20091216000117
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for ROBERT E EDMONSON (MD)

  • 221, West Colorado Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75208, United States

    STE 625

    DALLAS, TX 752082363

    Phone: (214) 946-5165

    Fax: (214) 946-4876

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-03-30 • Largest payer in this snapshot: Boston Scientific Corporation ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-30

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2009-12-16

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
I20091216000117ICardiovascular Disease (Cardiology)TXTBD

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 75208)

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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: 5597046672View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology), Interventional Cardiology, Peripheral Vascular DiseaseTX
Physician AssistantTX
Cardiovascular Disease (Cardiology)TX
Nurse PractitionerTX
Cardiovascular Disease (Cardiology)TX
Cardiovascular Disease (Cardiology)TX

Reviews

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Frequently asked questions

What NPI should I save for ROBERT E EDMONSON (MD)?
Save NPI 1124062005 if you need a stable reference for ROBERT E EDMONSON (MD).
Is ROBERT E EDMONSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is ROBERT E EDMONSON (MD)?
The page reflects Cardiovascular Disease Physician for ROBERT E EDMONSON (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for ROBERT E EDMONSON (MD)?
The page summarizes Dallas, Texas for ROBERT E EDMONSON (MD); expand the address list for detail.
Is ROBERT E EDMONSON (MD) a real provider?
This page reflects official NPPES data for NPI 1124062005. Always confirm identity and privileges with the practice and licensing boards.

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