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KUSI FORDJOUR M.D PA
NPI 1811101348
Internal Medicine in Desoto, TX

Active since May 10, 2007
2505 BOLTON BOONE DR, #101, DESOTO, TX 75115(972) 264-9100(972) 283-9104 Get Directions Write a Review

NPPES record last updated: May 25, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kusi Fordjour M.d Pa NPPES

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

KUSI FORDJOUR M.D PA (NPI 1811101348) is a healthcare organization registered as an internal medicine in Desoto, Texas and active in the NPI registry since May 2007. The organization lists Kusi Fordjour, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1811101348
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKUSI FORDJOUR M.D PA
Location Address2505 BOLTON BOONE DR, #101Desoto, TX 75115-2013
Mailing AddressPo Box 93597Southlake, TX 76092-0115 · (972) 264-9100 · Fax (972) 283-9104
Phone(972) 264-9100
Fax(972) 283-9104
Organization SubpartNo
Authorized OfficialKusi FordjourPresident And Ceo · (214) 673-3934
Enumeration DateMay 10, 2007
Last NPPES UpdateMay 25, 2011
✔ NPI 1811101348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · L0177
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2505 BOLTON BOONE DR, Desoto, TX 75115
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Other Identifiers 6

Other0098MTTX · Bcbs
Medicare UPINH10182TX
Medicare ID-Type Unspecified00647WTX · Medicrae Ind Number
Medicaid173380001TX
Medicare PIN8B8366TX
OtherL0177TX · Licence

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, WellPoint.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)

Kusi Fordjour M.d Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kusi Fordjour M.D PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Kusi Fordjour, MD
Internal Medicine
NPI 1780623074
2505 BOLTON BOONE DR STE 101
Desoto, TX 75115
(972) 283-9100
✔ PECOS✔ Accepts MedicareSame address
Deborah Larbie, FNP
Nurse Practitioner
NPI 1356717235
3334 BROADWAY BLVD STE 422
Garland, TX 75043
(972) 979-7408
✔ PECOS✔ Accepts Medicare22 mi

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 45D1090274

Kusi Fordjour,md, PA · Desoto, TX
Expired · Oct 6, 2026
CLIA Number45D1090274
Laboratory TypePhysician Office
Certificate Effective DateOctober 7, 2024
Certificate Expiration DateOctober 6, 2026
Laboratory DirectorKusi Fordjour,md
Laboratory Phone(214) 673-3934
Laboratory LocationKusi Fordjour,md, PA2505 Bolton Boone Dr Suite 101, Desoto, TX 75115
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Kusi Fordjour M.D PA's NPI number?

The NPI number for Kusi Fordjour M.D PA is 1811101348. It was assigned to this organization in the NPPES registry on May 10, 2007.

Where is Kusi Fordjour M.D PA located?

Kusi Fordjour M.D PA is located at 2505 Bolton Boone Dr #101, Desoto, TX 75115. The listed phone number is (972) 264-9100.

What is Kusi Fordjour M.D PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kusi Fordjour M.D PA enrolled in Medicare?

Yes. Kusi Fordjour M.D PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kusi Fordjour M.D PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Kusi Fordjour M.D PA, in Internal Medicine 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kusi Fordjour M.D PA accept?

Health plans from Molina Healthcare and WellPoint list Kusi Fordjour M.D 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 Kusi Fordjour M.D PA was last updated on May 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.