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MR. KENNETH JEROME HAMBY D.O.
NPI 1225278914
Family Medicine in Lindale, TX

Active since February 20, 2009PECOS EnrolledAccepts Medicare Assignment
14069 FM 849, LINDALE, TX 75771(903) 590-5263(903) 590-5261 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 5, 2020, Sep 6, 2019 (2 updates tracked since 2019).

About Mr. Kenneth Jerome Hamby D.o. NPPES

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

MR. KENNETH JEROME HAMBY D.O. (NPI 1225278914) is an individual family medicine provider in Lindale, Texas, licensed in Texas (V9044) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1225278914
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. KENNETH JEROME HAMBYCredential: D.O.
Location Address14069 FM 849Lindale, TX 75771-5160
Mailing Address14069 Fm 849Lindale, TX 75771-5160 · (903) 590-5263 · Fax (903) 590-5261
Phone(903) 590-5263
Fax(903) 590-5261
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateFebruary 20, 2009
Last NPPES UpdateSeptember 29, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2025
✔ NPI 1225278914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · V9044
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
14069 FM 849, Lindale, TX 75771
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Kenneth Jerome Hamby D.o. 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 ID7012061112
PECOS Enrollment IDI20090824000277
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.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Hamby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Etmc Physician Group Inc.
13 mi
Cardiovascular Disease
1000 S BECKHAM AVE
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • 636 clinicians in this Medicare group
NPI 1609382662 (903) 590-5611

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number450690
Location11937 Us Highway 271Tyler, TX 75708 · Smith County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75771 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
47%120 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
96%489 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
82%118 patients3/55-star benchmark: 100%
Elder Maltreatment Screen and Follow-Up Plan
Percentage of patients aged 65 years and older with a documented elder maltreatment screen using an Elder Maltreatment Screening Tool on the date of encounter AND a documented follow-up plan on the date of the positive screen
3%606 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
84%604 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
40%677 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
90%230 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers36 claims118 services$6.84 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers16 claims25 services$1.17 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers12 claims12 services$16.49 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers11 claims11 services$13.59 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers17 claims92 services$2.04 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers15 claims21 services$19.75 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

ETMC PHYSICIAN GROUP INC.
Clinic/Center (Rural Health)
14069 FM 849
LINDALE, TX 75771
Smith County (903) 590-5263
KAREN BOWERY NP
Nurse Practitioner (Family)
14069 FM 849
LINDALE, TX 75771
Smith County (903) 590-5263

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 Kenneth Hamby's NPI number?

The NPI number for Kenneth Hamby is 1225278914. It was assigned to this individual provider in the NPPES registry on February 20, 2009.

Where is Kenneth Hamby located?

Kenneth Hamby practices at 14069 Fm 849, Lindale, TX 75771. The listed phone number is (903) 590-5263.

What is Kenneth Hamby's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kenneth Hamby enrolled in Medicare?

Yes. Kenneth Hamby 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.

Which organization bills Medicare for Kenneth Hamby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Hamby reassigns Medicare benefits to Etmc Physician Group Inc. (Tyler, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Hamby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Hamby accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and Ambetter from Louisiana Healthcare Connections and 6 other insurers list Kenneth Hamby 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.

Is Kenneth Hamby affiliated with any hospitals?

According to CMS data, Kenneth Hamby is affiliated with Ut Health East Texas Tyler Regional Hospital and The University Of Texas Health Science Center At Tyler.

When was this NPI record last updated?

The NPPES record for Kenneth Hamby was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.