MEDI- ELITE, PC – Primary Care Clinic/Center, NPI 1528330792

MEDI- ELITE, PC is a healthcare provider. based in Arlington, Texas. specializing in Primary Care Clinic/Center. The organization holds a License No. AP117597 (TX). The NPI Number for MEDI- ELITE, PC is 1528330792

Main info

Organization
Name
MEDI- ELITE, PC
NPI
1528330792
Phone
(214) 277-2243
Address
4621 S COOPER ST STE 131-717
Authorized Official
DR. MAHALIA L JACKSON-BUTLER CEO DNP, APRN
Enumeration Date
3 February 2012
Last Update Date
24 November 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for MEDI- ELITE, PC

  • 4621 S COOPER ST STE 131-717

    ARLINGTON, TX 760175866

    Phone: (214) 277-2243

    Fax: (214) 231-2926

    Type: Location

  • 2721 CENTRAL DR

    BEDFORD, TX 760214810

    Phone: (682) 703-8881

    Fax: (706) 203-3259

    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: 2015-01-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (14 days ago).

Enrollment records

1

Earliest due date

2026-05-31

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
O20150129000075OClinic/Group PracticeTX2026-05-31

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 76017)

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Reviews

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Frequently asked questions

Does MEDI- ELITE, PC have a public NPI I can cite?
Public records show MEDI- ELITE, PC under NPI 1528330792.
Is MEDI- ELITE, PC currently accepting referrals based on NPI status?
Registry metadata lists MEDI- ELITE, PC as active.
What does the directory say MEDI- ELITE, PC does?
Insurance directories may phrase it differently, but here MEDI- ELITE, PC maps to Primary Care Clinic/Center. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MEDI- ELITE, PC?
MEDI- ELITE, PC is associated with Arlington, Texas in the same public data insurers reference.
Can I export MEDI- ELITE, PC's record?
You can download the official NPPES record; we summarize key fields for readability.

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