DEKALB PHYSICIANS CLINIC LLC
NPI 1265565691
Family Medicine in De Kalb, TX
About Dekalb Physicians Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEKALB PHYSICIANS CLINIC LLC (NPI 1265565691) is a healthcare organization registered as a family medicine in De Kalb, Texas and active in the NPI registry since March 2007. The organization lists Kyle Wayne Groom, Owner - Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dekalb Physicians Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Dekalb Physicians Clinic LLC, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D1044009
Dekalb Physicians Clinic · De Kalb, TXFrequently 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 Dekalb Physicians Clinic LLC's NPI number?
The NPI number for Dekalb Physicians Clinic LLC is 1265565691. It was assigned to this organization in the NPPES registry on March 14, 2007.
Where is Dekalb Physicians Clinic LLC located?
Dekalb Physicians Clinic LLC is located at 1250 S Runnels St, De Kalb, TX 75559. The listed phone number is (903) 667-2273.
What is Dekalb Physicians Clinic LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Dekalb Physicians Clinic LLC enrolled in Medicare?
Yes. Dekalb Physicians Clinic LLC is registered in the Medicare PECOS enrollment system.
When is Dekalb Physicians Clinic LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dekalb Physicians Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Dekalb Physicians Clinic LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (5) and Emergency Medicine (1). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Dekalb Physicians Clinic LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Dekalb Physicians Clinic LLC 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 Dekalb Physicians Clinic LLC was last updated on January 30, 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.
# Dekalb Physicians Clinic Llc · NPI 1265565691
Family Medicine organization in De Kalb, Texas. Organization record, active in the CMS NPPES registry since March 14, 2007.
## Identity
- **NPI:** 1265565691 (Entity type: Organization)
- **Enumerated:** March 14, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Kyle Groom, OWNER - PHYSICIAN
## Practice location
- **Address:** 1250 S RUNNELS ST, De Kalb, TX 75559-2317
- **Phone:** (903) 667-2273 · **Fax:** (903) 667-7597
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Emergency Medicine (1); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 30, 2023
- **Other identifiers:** Other 8S7090 (TX); Medicaid 177214701 (TX); Other 8P152 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1265565691) · Data from the CMS NPPES public registry.