MR. KURT FOSSUM (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1295793370
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. KURT FOSSUM (PHYSICIAN ASSISTANT)
2008 Nine Rd
Brady, TX 768257210
Phone: (325) 597-2901
Type: Location
23438 WOODLAWN RDG
SAN ANTONIO, TX 782592778
Phone: (210) 947-3994
Type: Mailing
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 782344504
Phone: (210) 916-5512
Type: Location
Yuma Proving Ground Health Clinic, 301, C Street, YPG Residential Area, Yuma County, Arizona, 85365, United States
BLDG 990
YUMA, AZ 853659498
Phone: (928) 328-2666
Type: Location
7629, East 25th Street, Desert Ridge, Araby, Yuma, Yuma County, Arizona, 85365, United States
YUMA, AZ 853657829
Phone: (910) 583-9932
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: 2016-06-29
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 |
|---|---|---|---|---|
| I20160629001797 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76825)
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