MARVIN DEAN PENNINGTON (PA) – Surgical Physician Assistant, NPI 1972534683
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for MARVIN DEAN PENNINGTON (PA)
3414, Golden Road, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757018336
Phone: (903) 939-7500
Fax: (800) 248-0426
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: 2004-01-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040103000028 | I | Physician Assistant | TX | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 72100 | X-ray of lower and sacral spine, 2-3 views | 221 | 167 | $0 |
| 22853 | Insertion of cage or mesh device to spine bone and disc space during spine fusion | 176 | 84 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 119 | 113 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 108 | 79 | $0 |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment | 93 | 53 | $0 |
Insurance plans in this area (ZIP 75701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | TX | |
| Orthopedic Surgery | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | LA | |
| P O D I A T R Y | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Hand Surgery, Orthopedic Surgery | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX |
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