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MCCOY CLEMENTSON DO
NPI 1689429029
Student in an Organized Health Care Education/Training Program in Corpus Christi, TX

Active since April 19, 2024PECOS EnrolledAccepts Medicare Assignment
600 ELIZABETH ST # 9B, CORPUS CHRISTI, TX 78404(361) 881-3000 Get Directions Write a Review

NPPES record last updated: June 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 5, 2026, Apr 19, 2024 (2 updates tracked since 2024).

About Mccoy Clementson Do NPPES

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

MCCOY CLEMENTSON DO (NPI 1689429029) is an individual student in an organized health care education/training program in Corpus Christi, Texas and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2024).

NPPES Registry Identity

NPI1689429029
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMCCOY CLEMENTSONCredential: DO
Location Address600 ELIZABETH ST # 9BCorpus Christi, TX 78404-2235
Mailing Address600 Elizabeth St # 9bCorpus Christi, TX 78404-2235 · (361) 881-3000
Phone(361) 881-3000
Sole ProprietorNo
Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2024
Enumeration DateApril 19, 2024
Last NPPES UpdateJune 5, 20262 updates tracked since enumeration
NPPES CertifiedJune 5, 2026
✔ NPI 1689429029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License W4074 (TX)
600 ELIZABETH ST # 9B, Corpus Christi, TX 78404
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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

Mccoy Clementson Do 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 ID3274098009
PECOS Enrollment IDI20260722000834
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 Mccoy Clementson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gulf Coast Emergency Physicians, PLLC
40 mi
Emergency Medicine
2500 E MAIN ST
Alice, TX 78332
  • Reassigned Medicare billing, Texas enrollment
  • 174 clinicians in this Medicare group
NPI 1972286920 (361) 661-8000

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

Other Providers at the Same Location NPPES 20

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

BRYAN COBURN DO
Emergency Medicine
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 881-3000
KENNETH WESLEY SLIMP DO
Student in an Organized Health Care Education/Training Program
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (817) 703-9158
DR. CHRISTOPHER ETHAN WINNIE MD
Student in an Organized Health Care Education/Training Program
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 881-3000
JAVINE DALE BISPOTT MD
Student in an Organized Health Care Education/Training Program
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 861-1861
TYLER ADAMS DO
Emergency Medicine
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 861-1864
MIRANDA MICHELE MINGEN DO
Student in an Organized Health Care Education/Training Program
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 861-1864
DR. DALIA DUZDAR MD
Emergency Medicine
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 861-1864
DHARTIBEN PATEL
Student in an Organized Health Care Education/Training Program
600 ELIZABETH ST # 9B
CORPUS CHRISTI, TX 78404
Nueces County (361) 861-1861

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 Mccoy Clementson's NPI number?

The NPI number for Mccoy Clementson is 1689429029. It was assigned to this individual provider in the NPPES registry on April 19, 2024.

Where is Mccoy Clementson located?

Mccoy Clementson practices at 600 Elizabeth St # 9B, Corpus Christi, TX 78404. The listed phone number is (361) 881-3000.

What is Mccoy Clementson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mccoy Clementson enrolled in Medicare?

Yes. Mccoy Clementson 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 Mccoy Clementson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mccoy Clementson reassigns Medicare benefits to Gulf Coast Emergency Physicians, PLLC (Alice, 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 Mccoy Clementson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mccoy Clementson was last updated on June 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.