CREEKSIDE PREMIER MEDICAL GROUP PLLC – Hematology & Oncology Physician, NPI 1487217006

CREEKSIDE PREMIER MEDICAL GROUP PLLC is a healthcare provider. based in Huntsville, Texas. specializing in Hematology & Oncology Physician. The NPI Number for CREEKSIDE PREMIER MEDICAL GROUP PLLC is 1487217006

Main info

Organization
Name
CREEKSIDE PREMIER MEDICAL GROUP PLLC
NPI
1487217006
Phone
(346) 522-2550
Address
130 Medical Center Pkwy Ste 6B
Authorized Official
DAVID P ELLENT PRESIDENT MD
Enumeration Date
18 April 2019
Last Update Date
27 August 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:7State licenses:0Digital endpointsOther names

Provider Addresses for CREEKSIDE PREMIER MEDICAL GROUP PLLC

  • 130 Medical Center Pkwy Ste 6B

    Huntsville, TX 773404943

    Phone: (346) 522-2550

    Type: Location

  • 3466 Discovery Creek Blvd Ste 600

    Spring, TX 773867129

    Phone: (346) 522-2550

    Type: Location

  • 790 Generations Dr Ste 500B

    New Braunfels, TX 781302613

    Phone: (346) 522-2550

    Type: Location

  • 1710 W Lake Houston Pkwy Ste 260B

    Kingwood, TX 773392571

    Phone: (346) 522-2550

    Type: Location

  • 24727 State Highway 249 # 120B

    Tomball, TX 773757877

    Phone: (346) 522-2550

    Type: Location

  • 2255 E Mossy Oaks Rd Ste 500

    Spring, TX 773891813

    Phone: (346) 522-2550

    Type: Location

  • 2255 E MOSSY OAKS RD STE 500

    SPRING, TX 773891813

    Phone: (281) 440-5300

    Type: Location

  • 26940 KUYKENDAHL RD STE 200B

    TOMBALL, TX 773753533

    Phone: (346) 522-2550

    Type: Location

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: 2023-11-16

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
O20231116000915OClinic/Group PracticeTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77340)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for CREEKSIDE PREMIER MEDICAL GROUP PLLC?
CREEKSIDE PREMIER MEDICAL GROUP PLLC — NPI 1487217006 — is the standard way to identify this listing.
Does CMS list CREEKSIDE PREMIER MEDICAL GROUP PLLC as active?
Yes — CREEKSIDE PREMIER MEDICAL GROUP PLLC is active in the NPI listing used on this page.
What taxonomy line describes CREEKSIDE PREMIER MEDICAL GROUP PLLC?
For research purposes, treat CREEKSIDE PREMIER MEDICAL GROUP PLLC as Hematology & Oncology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does CREEKSIDE PREMIER MEDICAL GROUP PLLC serve?
CREEKSIDE PREMIER MEDICAL GROUP PLLC's listing highlights Huntsville, Texas; more addresses can appear in NPPES.
Is the information about CREEKSIDE PREMIER MEDICAL GROUP PLLC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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