KATRINA L WILLIE-MUSOMA (MD) – Pediatric Neurodevelopmental Disabilities Physician, NPI 1003023979
Pediatric Neurodevelopmental Disabilities Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KATRINA L WILLIE-MUSOMA (MD)
1500 COOPER ST
FORT WORTH, TX 761042710
Phone: (682) 303-9300
Fax: (682) 303-9245
Type: Location
East Broad Street, Mansfield, Tarrant County, Texas, 76063, United States
MANSFIELD, TX 760636410
Phone: (817) 557-5437
Fax: (817) 539-0476
Type: Location
PO BOX 733784
DALLAS, TX 753733784
Phone: (682) 885-6483
Fax: (682) 885-3113
Type: Mailing
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: 2008-08-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080806000270 | I | Pediatric Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76104)
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