KEVIN SKINNER (PA) – Physician Assistant, NPI 1164790721
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KEVIN SKINNER (PA)
PO BOX 846098
DALLAS, TX 752846098
Phone: (903) 606-6400
Type: Mailing
800 E DAWSON ST
TYLER, TX 757012036
Phone: (903) 593-8441
Type: Location
PO BOX 841656
DALLAS, TX 752841656
Phone: (903) 531-5000
Type: Mailing
115 Airport Rd
Sulphur Springs, TX 754822105
Phone: (903) 885-7671
Type: Location
18780 Interstate 20
Canton, TX 751033593
Phone: (903) 567-7748
Type: Location
2026 S Jackson St
Jacksonville, TX 757665822
Phone: (903) 541-4500
Type: Location
8389 S Broadway Ave
Tyler, TX 757035408
Phone: (903) 606-6500
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: 2012-03-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120316000458 | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 32 | 32 | $0 |
Insurance plans in this area (ZIP 75284)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| - | TX | |
| Nurse Practitioner | AZ | |
| Physician Assistant | UT | |
| Nurse Practitioner | TX | |
| Emergency Medicine | TX | |
| Physician Assistant | AR | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX |
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