PELICAN MEDICAL SPECIALISTS PLLC – Multi-Specialty Clinic/Center, NPI 1902380009

PELICAN MEDICAL SPECIALISTS PLLC is a healthcare provider. based in Coppell, Texas. specializing in Multi-Specialty Clinic/Center. The NPI Number for PELICAN MEDICAL SPECIALISTS PLLC is 1902380009

Main info

Organization
Name
PELICAN MEDICAL SPECIALISTS PLLC
NPI
1902380009
Phone
(718) 809-7792
Address
405 HOOD CT
Authorized Official
MOHAMMED MOIZUDDIN DIRECTOR
Enumeration Date
24 September 2018
Last Update Date
26 December 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:7State licenses:0Digital endpointsOther names

Provider Addresses for PELICAN MEDICAL SPECIALISTS PLLC

  • 405, Hood Court, Coppell, Dallas County, Texas, 75019, United States

    COPPELL, TX 750192758

    Phone: (718) 809-7792

    Type: Mailing

  • 1022 KENILWORTH ST

    ALLEN, TX 750135828

    Phone: (972) 674-9910

    Fax: (972) 666-5166

    Type: Mailing

  • 5012 US HWY 75 STE 120

    DENISON, TX 750204587

    Phone: (972) 674-9910

    Type: Location

  • 931 STATE HIGHWAY 121 STE 1100

    ALLEN, TX 750131180

    Phone: (972) 674-9910

    Fax: (972) 666-5166

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2019-09-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-09-30 (617 days ago).

Enrollment records

1

Earliest due date

2024-09-30

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
O20190912000680OClinic/Group PracticeTX2024-09-30

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 75019)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is PELICAN MEDICAL SPECIALISTS PLLC identified in CMS data?
CMS-hosted NPPES data lists PELICAN MEDICAL SPECIALISTS PLLC with NPI 1902380009.
Is PELICAN MEDICAL SPECIALISTS PLLC listed as active for patients and plans?
The listing shows PELICAN MEDICAL SPECIALISTS PLLC as active in the NPI system.
What is PELICAN MEDICAL SPECIALISTS PLLC best known for clinically?
Directory data describes PELICAN MEDICAL SPECIALISTS PLLC with Multi-Specialty Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is PELICAN MEDICAL SPECIALISTS PLLC based?
PELICAN MEDICAL SPECIALISTS PLLC is tied to Coppell, Texas in the data we show; additional addresses may exist on the full record.
Why does PELICAN MEDICAL SPECIALISTS PLLC have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

Similar Providers

RECOVERY COMMUNITIES OF CULTURE

Substance Use Disorder Rehabilitation Clinic/Center
PO BOX 3472
NPI: 1962829408

TEXAS PARTNERS HEALTHCARE GROUP, PA

Interventional Pain Medicine Physician
305 Regency Pkwy Ste 805
NPI: 1689119463

Inkure U Wellness Center

Adult Health Nurse Practitioner
Elmbrook Drive, Dallas, TX, Dallas, Dallas County, Texas, 75247, United States
NPI: 1972068526

Rapid City Healthcare Primary Care

Primary Care Clinic/Center
800 W AIRPORT FWY STE 100
NPI: 1558930693

Rapid City Urgent Care

Urgent Care Clinic/Center
524 WALES CT
NPI: 1215503818

AMERICA FIRST PRIMARY CARE PLLC

Multi-Specialty Clinic/Center
809 S MACARTHUR BLVD STE 400
NPI: 1922675347