KELLY BRENNAN – Physician Assistant, NPI 1376309039

KELLY BRENNAN is a healthcare provider. based in Arlington, Texas. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA17677 (TX). The NPI Number for KELLY BRENNAN is 1376309039

Main info

Female
3 Years Of Experience
Name
KELLY BRENNAN
NPI
1376309039
Phone
(817) 419-0303
Address
3533 MATLOCK RD
Enumeration Date
21 February 2024
Last Update Date
9 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8174190303
Graduation Year
2023 (3 years ago)
PAC ID
9032551221
Group Practice PAC ID
1052399508
Professional Enrollment ID
I20240520001407
Address ID
TX760153604AR3533XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for KELLY BRENNAN

  • 3533 MATLOCK RD

    ARLINGTON, TX 760153604

    Phone: (817) 419-0303

    Fax: (833) 626-1951

    Type: Location

  • 76 Regency Pkwy

    Mansfield, TX 760637816

    Phone: (817) 419-0303

    Fax: (833) 626-1951

    Type: Location

  • 2535 IRA E WOODS AVE

    GRAPEVINE, TX 760513930

    Phone: (817) 481-2121

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 53 Open Payments records for all available years, with a total value of $5,200.

Total Amount is formed as General ($5,200) + Research ($0) + Ownership ($0) = $5,200.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Arthrex, Inc. ($1,567).

Total Amount

$5,200

General + Research + Ownership

Payments

53

Total payment records

General Amount

$5,200

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

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: 2024-05-20

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
I20240520001407IPhysician AssistantTXTBD

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 76015)

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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: 1052399508View full group profile
NameSpecialtyState
Physician AssistantTX
Orthopedic SurgeryTX
Physician AssistantTX
Orthopedic SurgeryTX
Physician AssistantTX
Physician AssistantWI
Orthopedic Surgery, Hand SurgeryNC
Physician AssistantTX
Orthopedic Surgery, Sports MedicineTX
Physician AssistantAZ

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLY BRENNAN?
KELLY BRENNAN — NPI 1376309039 — is the standard way to identify this listing.
Does CMS list KELLY BRENNAN as active?
Yes — KELLY BRENNAN is active in the NPI listing used on this page.
What taxonomy line describes KELLY BRENNAN?
For research purposes, treat KELLY BRENNAN as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where is KELLY BRENNAN based?
KELLY BRENNAN is tied to Arlington, Texas in the data we show; additional addresses may exist on the full record.
Is the information about KELLY BRENNAN up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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