GENESIS GYNECOLOGY PA – Gynecology Physician, NPI 1174792733

GENESIS GYNECOLOGY PA is a healthcare provider. based in Kerrville, Texas. specializing in Gynecology Physician. The NPI Number for GENESIS GYNECOLOGY PA is 1174792733

Main info

Organization
Name
GENESIS GYNECOLOGY PA
NPI
1174792733
Phone
(830) 792-0805
Address
176 FAIRWAY DR
Authorized Official
KERRI LEE TRUELOCK PRESIDENT MD
Enumeration Date
27 February 2008
Last Update Date
13 March 2013
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:18State licenses:0Digital endpointsOther names

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Provider Addresses for GENESIS GYNECOLOGY PA

  • 176, Fairway Drive, Riverhill, Kerrville, Kerr County, Texas, 78028, United States

    KERRVILLE, TX 780286437

    Phone: (830) 792-0805

    Fax: (830) 792-0833

    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: 2008-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-07-31 (677 days ago).

Enrollment records

1

Earliest due date

2024-07-31

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
O20080609000585OClinic/Group PracticeTX2024-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 78028)

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Reviews

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Frequently asked questions

How do I look up GENESIS GYNECOLOGY PA by NPI?
Use NPI 1174792733 when you need to reference GENESIS GYNECOLOGY PA in forms, claims, or directories.
Is GENESIS GYNECOLOGY PA's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize GENESIS GYNECOLOGY PA's specialty in plain language?
Clinically, the directory lists GENESIS GYNECOLOGY PA with Gynecology Physician. Clinical services aligned with this taxonomy classification.
What location shows for GENESIS GYNECOLOGY PA?
We surface Kerrville, Texas for GENESIS GYNECOLOGY PA 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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