Kelsom Clinic PA
NPI 1104840594 · Family Medicine Physician · Irving, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kelsom Clinic PA is a Family Medicine Physician organization in Irving, TX (NPI 1104840594).
Provider details
- NPI number
- 1104840594
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Kelsom Clinic PA
- Organization subpart
- Yes
- Authorized official
- Catherine Okoronkwo, MD(972) 254-7272
- License
- K2252 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 3220 Gus Thomasson Rd Ste 113Suite 113Mesquite, TX 75150-4051Phone: (972) 279-7373Fax: (972) 254-7272
Registry dates
- Enumerated
- 2006-07-27
- Last updated
- 2026-01-20
- Certified
- 2026-01-20
Frequently asked questions
- What is Kelsom Clinic PA's NPI number?
- Kelsom Clinic PA's National Provider Identifier (NPI) is 1104840594, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kelsom Clinic PA?
- Kelsom Clinic PA is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Kelsom Clinic PA located?
- Kelsom Clinic PA's practice location on file with NPPES is 1202 W Pioneer Dr Ste 100, Irving, TX 75061-7309.
- What is Kelsom Clinic PA's phone number?
- The practice phone number listed in the NPPES registry for Kelsom Clinic PA is (972) 254-7272.
- Does Kelsom Clinic PA accept Medicare?
- Kelsom Clinic PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kelsom Clinic PA?
- The authorized official listed on Kelsom Clinic PA's NPPES record is Catherine Okoronkwo, MD. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kelsom Clinic PA's NPI active?
- Yes — Kelsom Clinic PA's NPI (1104840594) is active in the NPPES registry as of the last update on 2026-01-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.