KYLE MITCHELL KOELKER (PA-C) – Physician Assistant, NPI 1619535366

KYLE MITCHELL KOELKER (PA-C) is a healthcare provider. based in Kaufman, Texas. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA12753 (TX). The NPI Number for KYLE MITCHELL KOELKER (PA-C) is 1619535366

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
KYLE MITCHELL KOELKER (PA-C)
NPI
1619535366
Phone
(214) 256-3778
Address
874 Ed Hall Dr Ste 104
Enumeration Date
29 May 2019
Last Update Date
19 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2549651505
Graduation Year
2018 (8 years ago)
PAC ID
4183950876
Group Practice PAC ID
8921235516
Professional Enrollment ID
I20190802000916
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Digital endpointsOther names

Provider Addresses for KYLE MITCHELL KOELKER (PA-C)

  • 874 Ed Hall Dr Ste 104

    Kaufman, TX 751421800

    Phone: (214) 256-3778

    Type: Location

  • 351, East Tarleton Street, Stephenville, Erath County, Texas, 76401, United States

    STEPHENVILLE, TX 764013511

    Phone: (254) 968-0292

    Fax: (888) 289-1607

    Type: Location

  • 1860 CRESTLAND DR

    LUCAS, TX 750028566

    Phone: (972) 835-9582

    Type: Mailing

  • 222 S COLLINS RD STE 101

    SUNNYVALE, TX 751824645

    Phone: (512) 519-1254

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $71.

Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.

Last reported payment date: 2024-08-22 • Largest payer in this snapshot: Bioventus LLC ($21).

Total Amount

$71

General + Research + Ownership

Payments

4

Total payment records

General Amount

$71

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-22

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: 2019-08-02

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
I20190802000916IPhysician 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
27447Replacement of knee joint, both sides of knee8883$0
27130Replacement of thigh bone and hip joint with prosthesis4443$0
27446Replacement of knee joint on side of knee2020$0
View full utilization report →

Insurance plans in this area (ZIP 75142)

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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: 8921235516View full group profile
NameSpecialtyState
Physician AssistantTX
Nurse PractitionerTX
Orthopedic SurgeryTX

Reviews

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Frequently asked questions

What is KYLE MITCHELL KOELKER (PA-C)'s NPI number?
KYLE MITCHELL KOELKER (PA-C)'s NPI is 1619535366 — the number used across U.S. healthcare to identify this provider.
Would KYLE MITCHELL KOELKER (PA-C) appear as active to a payer?
You can treat KYLE MITCHELL KOELKER (PA-C) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with KYLE MITCHELL KOELKER (PA-C)?
KYLE MITCHELL KOELKER (PA-C)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Is KYLE MITCHELL KOELKER (PA-C) located near Kaufman?
KYLE MITCHELL KOELKER (PA-C) currently maps to Kaufman, Texas in this extract.
When was this NPI issued?
Enumeration for KYLE MITCHELL KOELKER (PA-C) is noted as May 29, 2019 where the registry provides it.

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