KEVIN DEIDRICK – Primary Podiatric Medicine Podiatrist, NPI 1538746110

KEVIN DEIDRICK is a healthcare provider. based in Temple, Texas. specializing in PODIATRY. They hold a License No. 692126 (TX). The NPI Number for KEVIN DEIDRICK is 1538746110

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN DEIDRICK
NPI
1538746110
Phone
(916) 390-1680
Address
2401 S 31ST ST
Enumeration Date
28 March 2021
Last Update Date
17 May 2024

Doctor Profile

Medical School Name
R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Secondary Phone
2547242663
Graduation Year
2021 (5 years ago)
PAC ID
8628470242
Group Practice PAC ID
8123923604
Professional Enrollment ID
I20240719002769
Address ID
TX765080001TE2401XBLDG501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,098 PODIATRY in TX

Provider Addresses for KEVIN DEIDRICK

  • 2401 S 31ST ST

    TEMPLE, TX 765080001

    Phone: (916) 390-1680

    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 24 Open Payments records for all available years, with a total value of $1,816.

Total Amount is formed as General ($1,816) + Research ($0) + Ownership ($0) = $1,816.

Last reported payment date: 2024-06-18 • Largest payer in this snapshot: Medinc of Texas ($746).

Total Amount

$1,816

General + Research + Ownership

Payments

24

Total payment records

General Amount

$1,816

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-18

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: 2024-07-19

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
I20240719002769IPodiatryTXTBD

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 76508)

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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: 8123923604View full group profile
NameSpecialtyState
Radiation OncologyTX
U R O L O G YTX
General SurgeryOK
Certified Registered Nurse Anesthetist (Crna)TX
-TX
Anesthesiology AssistantTX
-TX
-TX
O B S T E T R I C S/ G Y N E C O L O G YTX
-TX

Reviews

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Frequently asked questions

What unique ID ties claims to KEVIN DEIDRICK?
NPI 1538746110 is assigned to KEVIN DEIDRICK under the national enumeration system.
Is KEVIN DEIDRICK's NPI currently valid?
The extract we use shows KEVIN DEIDRICK as active.
What kind of provider is KEVIN DEIDRICK?
The page reflects Primary Podiatric Medicine Podiatrist for KEVIN DEIDRICK. Clinical services aligned with this taxonomy classification.
What location metadata exists for KEVIN DEIDRICK?
The page summarizes Temple, Texas for KEVIN DEIDRICK; expand the address list for detail.
How can I contact KEVIN DEIDRICK?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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