STEVEN RAY EDMONDSON (MD) – Obstetrics & Gynecology Physician, NPI 1164429890

STEVEN RAY EDMONDSON (MD) is a healthcare provider. based in Fort worth, Texas. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. G8830 (TX). The NPI Number for STEVEN RAY EDMONDSON (MD) is 1164429890

Main info

Male
Sole Proprietor
42 Years Of Experience
Accepts Medicare Assignment
Name
STEVEN RAY EDMONDSON (MD)
NPI
1164429890
Phone
(817) 431-1500
Address
3025 N TARRANT PKWY
Enumeration Date
7 July 2005
Last Update Date
15 October 2016

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
2815407700
Graduation Year
1984 (42 years ago)
PAC ID
8820272917
Group Practice PAC ID
0042283921
Professional Enrollment ID
I20110414000404
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

3,164 OBSTETRICS/GYNECOLOGY in TX

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Provider Addresses for STEVEN RAY EDMONDSON (MD)

  • North Tarrant Parkway, Fort Worth, Tarrant County, Texas, 76131, United States

    SUITE 240

    FORT WORTH, TX 761778620

    Phone: (817) 431-1500

    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: 2011-04-14

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
I20110414000404IObstetrics/GynecologyTXTBD

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 76177)

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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: 0042283921View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YTX
-NC
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YMN
-TX
-TX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX

Reviews

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Frequently asked questions

What federal number belongs to STEVEN RAY EDMONDSON (MD)?
The federal identifier for STEVEN RAY EDMONDSON (MD) is NPI 1164429890.
Is STEVEN RAY EDMONDSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does STEVEN RAY EDMONDSON (MD) work in?
You can think of STEVEN RAY EDMONDSON (MD) as practicing within Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place STEVEN RAY EDMONDSON (MD)?
The snapshot lists Fort Worth, Texas for STEVEN RAY EDMONDSON (MD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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