KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC – Psychiatric/Mental Health Nurse Practitioner, NPI 1639996242

KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC is a healthcare provider. based in Haslet, Texas. specializing in Psychiatric/Mental Health Nurse Practitioner. The NPI Number for KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC is 1639996242

Main info

Organization
Name
KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC
NPI
1639996242
Phone
(347) 378-3144
Address
548 WESTWOOD WAY DR
Authorized Official
KEMISOLA EBIETOMIYE OWNER OF ENTITY
Enumeration Date
24 September 2024
Last Update Date
14 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

Provider Addresses for KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC

  • 548 WESTWOOD WAY DR

    HASLET, TX 760523079

    Phone: (347) 378-3144

    Fax: (469) 242-9827

    Type: Mailing

  • 109 N 12TH ST STE 704

    BROOKLYN, NY 112491002

    Phone: (347) 378-3144

    Fax: (469) 242-9827

    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: 2025-03-10

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
O20250310003176OClinic/Group PracticeNJTBD

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 76052)

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Reviews

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Frequently asked questions

What NPI should I save for KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC?
Save NPI 1639996242 if you need a stable reference for KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC.
Is KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC active in the national directory?
KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC's public NPI profile is in an active state.
Can you summarize KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC's specialty in plain language?
Clinically, the directory lists KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC?
The snapshot lists Haslet, Texas for KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC; download NPPES for the complete set.
Is KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC a real provider?
This page reflects official NPPES data for NPI 1639996242. Always confirm identity and privileges with the practice and licensing boards.

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