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TERESA D KOWALCZYK MD
NPI 1538170261
Obstetrics & Gynecology - Gynecology in Greenville, TX

Active since August 10, 2006PECOS EnrolledAccepts Medicare Assignment
4221 RIDGECREST RD, SUITE 109, GREENVILLE, TX 75402(903) 455-9582(903) 455-5689 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Teresa D Kowalczyk Md NPPES

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

TERESA D KOWALCZYK MD (NPI 1538170261) is an individual gynecology provider in Greenville, Texas, licensed in Texas (K4932) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Hunt Regional Medical Center, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1538170261
Entity TypeIndividualFemale
Primary Taxonomy207VG0400X
Provider Legal NameTERESA D KOWALCZYKCredential: MD
Location Address4221 RIDGECREST RD, SUITE 109Greenville, TX 75402-6005
Mailing Address4221 Ridgecrest, Suite 109Greenville, TX 75402 · (903) 455-9582 · Fax (903) 455-5689
Phone(903) 455-9582
Fax(903) 455-5689
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateAugust 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1538170261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License✔ Licensed in TX · K4932
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
4221 RIDGECREST RD, Greenville, TX 75402
Open in Google Maps ↗

Other Identifiers 1

Other752941533TX · Tax Identification Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Teresa D Kowalczyk Md 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 ID5395747794
PECOS Enrollment IDI20110927000336
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 Revalidation Due Date

Revalidation due by January 31, 2027

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.

StateEnrollment IDDue date
StateTexasEnrollment IDO20071005000615Part A · HospitalDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Medicare Billing Reassignment

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

Greenville Womens Wellness Center
Same address
Obstetrics & Gynecology
4221 RIDGECREST RD STE 109
Greenville, TX 75402
  • Reassigned Medicare billing, Texas enrollment
NPI 1043357023 (903) 455-9582

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

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
136 services75 patients
Manual urinalysis test with examination using microscope, non-automated 81000
A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.
116 services100 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
105 services84 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
53 services53 patients
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory Q0091
A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.
50 services50 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
33 services29 patients

Hospital Affiliations CMS Care Compare

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

Hunt Regional Medical Center

Acute Care Hospitals · Greenville, TX
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450352
Location4215 Joe Ramsey Blvd EGreenville, TX 75401 · Hunt County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75402 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
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 4

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

JACOB CHUN MD PA
Orthopaedic Surgery
4221 RIDGECREST RD, SUITE101
GREENVILLE, TX 75402
Hunt County (903) 455-0300
GREENVILLE PULMONARY ASSOCIATES,PA
Internal Medicine (Critical Care Medicine)
4221 RIDGECREST RD, STE 107
GREENVILLE, TX 75402
Hunt County (903) 454-9976
MALISSIA D ZAPATA MD
Obstetrics & Gynecology (Gynecology)
4221 RIDGECREST RD, SUITE 109
GREENVILLE, TX 75402
Hunt County (903) 455-9582
ZAPATA WOMEN'S HEALTH CENTER, P.C.
Obstetrics & Gynecology
4221 RIDGECREST RD, #103
GREENVILLE, TX 75402
Hunt County (903) 454-2130

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 Teresa Kowalczyk's NPI number?

The NPI number for Teresa Kowalczyk is 1538170261. It was assigned to this individual provider in the NPPES registry on August 10, 2006.

Where is Teresa Kowalczyk located?

Teresa Kowalczyk practices at 4221 Ridgecrest Rd Suite 109, Greenville, TX 75402. The listed phone number is (903) 455-9582.

What is Teresa Kowalczyk's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Is Teresa Kowalczyk enrolled in Medicare?

Yes. Teresa Kowalczyk 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.

When is Teresa Kowalczyk's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this provider (Texas, Hospital) is due for revalidation by January 31, 2027. 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.

Which organization bills Medicare for Teresa Kowalczyk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Teresa Kowalczyk reassigns Medicare benefits to Greenville Womens Wellness Center (Greenville, 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 Teresa Kowalczyk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Teresa Kowalczyk accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Blue Cross and Blue Shield of Texas, UnitedHealthcare and WellPoint list Teresa Kowalczyk 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 Teresa Kowalczyk affiliated with any hospitals?

According to CMS data, Teresa Kowalczyk is affiliated with Hunt Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Teresa Kowalczyk was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.