TRISTYN DANIELLE EDGAR – Student in an Organized Health Care Education/Training Program, NPI 1417730102

TRISTYN DANIELLE EDGAR is a healthcare provider. based in Midland, Texas. specializing in PHYSICIAN ASSISTANT. The NPI Number for TRISTYN DANIELLE EDGAR is 1417730102

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
TRISTYN DANIELLE EDGAR
NPI
1417730102
Phone
Not provided
Address
3600 N GARFIELD ST
Enumeration Date
16 August 2023
Last Update Date
16 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9182722882
Graduation Year
2025 (1 year ago)
PAC ID
6709365067
Group Practice PAC ID
3971509381
Professional Enrollment ID
I20260206001425
Address ID
OK740554495OW9003XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for TRISTYN DANIELLE EDGAR

  • 3600 N GARFIELD ST

    MIDLAND, TX 797056329

    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)

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: 2026-02-06

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
I20260206001425IPhysician AssistantOKTBD

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 79705)

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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: 3971509381View full group profile
NameSpecialtyState
Nurse PractitionerOK
Family Practice, Emergency MedicineOK
Nurse PractitionerOK
Nurse PractitionerOK
Physician AssistantOK
Physician AssistantOK
Emergency Medicine, Family PracticeOK
Nurse PractitionerOK
Physician AssistantKS
Physician AssistantOK

Reviews

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Frequently asked questions

Where can patients find TRISTYN DANIELLE EDGAR's NPI?
You can confirm TRISTYN DANIELLE EDGAR with NPI 1417730102; it appears in the national provider directory.
Does this profile mean TRISTYN DANIELLE EDGAR is currently active?
Yes — TRISTYN DANIELLE EDGAR appears active in the national provider directory.
What field does TRISTYN DANIELLE EDGAR work in?
You can think of TRISTYN DANIELLE EDGAR as practicing within Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
What location shows for TRISTYN DANIELLE EDGAR?
We surface Midland, Texas for TRISTYN DANIELLE EDGAR based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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