KELLUM MEDICAL GROUP, PA
NPI 1508813494
Family Medicine in San Antonio, TX
About Kellum Medical Group, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLUM MEDICAL GROUP, PA (NPI 1508813494) is a healthcare organization registered as a family medicine in San Antonio, Texas and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through October 2, 2028 and lists Kristi Braker, Contract Management, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Identifiers 13
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kellum Medical Group, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Kellum Medical Group, PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
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 45D0671939
Kellum Medical Group, PA · San Antonio, 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 Kellum Medical Group, PA's NPI number?
The NPI number for Kellum Medical Group, PA is 1508813494. It was assigned to this organization in the NPPES registry on May 27, 2006.
Where is Kellum Medical Group, PA located?
Kellum Medical Group, PA is located at 7323 Marbach Rd Ste 104, San Antonio, TX 78227. The listed phone number is (210) 674-0257.
What is Kellum Medical Group, PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kellum Medical Group, PA enrolled in Medicare?
Yes. Kellum Medical Group, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kellum Medical Group, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Kellum Medical Group, PA, in Family Practice and Nurse Practitioner. 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. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Kellum Medical Group, PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D0671939) is associated with this NPI, valid through October 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Kellum Medical Group, PA accept?
Health plans from Blue Cross and Blue Shield of Texas list Kellum Medical Group, PA 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 Kellum Medical Group, PA was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Kellum Medical Group, Pa · NPI 1508813494
Family Medicine organization in San Antonio, Texas. Organization record, active in the CMS NPPES registry since May 27, 2006.
## Identity
- **NPI:** 1508813494 (Entity type: Organization)
- **Enumerated:** May 27, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Kristi Braker, CONTRACT MANAGEMENT
## Practice location
- **Address:** 7323 MARBACH RD STE 104, San Antonio, TX 78227-1905
- **Phone:** (210) 674-0257 · **Fax:** (210) 369-9064
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Nurse Practitioner (2); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 9, 2026
- **Other identifiers:** Other 45D1026258 (TX); Other 1174518625 (TX); Other CH6982 (TX); and 10 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508813494) · Data from the CMS NPPES public registry.