KELLIE LYN FLAHERTY (PA) – Physician Assistant, NPI 1265988208

KELLIE LYN FLAHERTY (PA) is a healthcare provider. based in Texarkana, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for KELLIE LYN FLAHERTY (PA) is 1265988208

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE LYN FLAHERTY (PA)
NPI
1265988208
Phone
Not provided
Address
2604 SAINT MICHAEL DR
Enumeration Date
30 August 2016
Last Update Date
30 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4098997680
Graduation Year
2016 (10 years ago)
PAC ID
6709162928
Group Practice PAC ID
7810342672
Professional Enrollment ID
I20170424000969
Address ID
TX777021809BE2830XSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

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Provider Addresses for KELLIE LYN FLAHERTY (PA)

  • 2604, Saint Michael Drive, Texarkana, Bowie County, Texas, 75503, United States

    SUITE 340

    TEXARKANA, TX 755032379

    Phone:

    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 2 Open Payments records for all available years, with a total value of $161.

Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.

Last reported payment date: 2023-03-31 • Largest payer in this snapshot: ABIOMED ($144).

Total Amount

$161

General + Research + Ownership

Payments

2

Total payment records

General Amount

$161

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-31

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2025-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20170424000969IPhysician AssistantTXTBD
I20250908002015IPhysician AssistantVTTBD

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
99291Critical care, first 30-74 minutes266152$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes3838$0
36556Insertion of non-tunneled central venous tube for infusion (5 years or older)3232$0
31500Emergent insertion of breathing tube into windpipe using an endoscope2121$0
36140Insertion of needle or tube into artery of arm or leg1414$0
View full utilization report →

Insurance plans in this area (ZIP 75503)

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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: 7810342672View full group profile
NameSpecialtyState
Pulmonary Disease, Critical Care (Intensivists)TX
Nurse PractitionerTX
Nurse PractitionerOK
Critical Care (Intensivists), AnesthesiologyTX
Pulmonary Disease, Critical Care (Intensivists)TX
Nurse PractitionerTX
Nurse PractitionerIN
Nurse PractitionerTX
Pulmonary Disease, Critical Care (Intensivists)CA
Nurse PractitionerTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLIE LYN FLAHERTY (PA)?
KELLIE LYN FLAHERTY (PA) — NPI 1265988208 — is the standard way to identify this listing.
Is KELLIE LYN FLAHERTY (PA) listed as active for patients and plans?
The listing shows KELLIE LYN FLAHERTY (PA) as active in the NPI system.
What is KELLIE LYN FLAHERTY (PA)'s specialty?
The listing groups KELLIE LYN FLAHERTY (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does KELLIE LYN FLAHERTY (PA) serve?
KELLIE LYN FLAHERTY (PA)'s listing highlights Texarkana, Texas; more addresses can appear in NPPES.
Is the information about KELLIE LYN FLAHERTY (PA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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