EDWARD RYAN KISSAM AG-ACNP
NPI 1194400473
Nurse Practitioner - Acute Care in Fort Sam Houston, TX

Active since June 15, 2023PECOS EnrolledAccepts Medicare Assignment
3551 ROGER BROOKE DR BLDG 3600, FORT SAM HOUSTON, TX 78234(210) 916-8003 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edward Ryan Kissam Ag-acnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD RYAN KISSAM AG-ACNP (NPI 1194400473) is an individual acute care provider in Fort Sam Houston, Texas, licensed in Texas (1106762) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1194400473
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameEDWARD RYAN KISSAMCredential: AG-ACNP
Location Address3551 ROGER BROOKE DR BLDG 3600Fort Sam Houston, TX 78234-4504
Mailing Address3551 Roger Brooke Dr Bldg 3600Fort Sam Houston, TX 78234-4504 · (210) 916-8003
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJune 15, 2023
NPPES CertifiedJune 15, 2023
NPI 1194400473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in TX · 1106762
3551 ROGER BROOKE DR BLDG 3600, Fort Sam Houston, TX 78234

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Edward Ryan Kissam Ag-acnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557896313
PECOS Enrollment IDI20241203001896
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78234 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Practice
3551 ROGER BROOKE DR BLDG 3600
JBSA FT SAM HOUSTON, TX 78234
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Plastic Surgery
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Physician Assistant (Medical)
3551 ROGER BROOKE DR BLDG 3600
SAN ANTONIO, TX 78234
Physician Assistant
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Psychologist (Clinical)
3551 ROGER BROOKE DR BLDG 3600
SAN ANTONIO, TX 78234
Plastic Surgery
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Dentist
3551 ROGER BROOKE DR BLDG 3600
JBSA FT SAM HOUSTON, TX 78234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Kissam's NPI number?

The NPI number for Edward Kissam is 1194400473. It was assigned to this individual provider in the NPPES registry on June 15, 2023.

Where is Edward Kissam located?

Edward Kissam practices at 3551 Roger Brooke Dr Bldg 3600, Fort Sam Houston, TX 78234. The listed phone number is (210) 916-8003.

What is Edward Kissam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Edward Kissam enrolled in Medicare?

Yes. Edward Kissam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edward Kissam accept?

Health plans from Blue Cross and Blue Shield of Texas and Molina Healthcare list Edward Kissam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edward Kissam was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.