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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KATHY SHUM ELLINGTON D.O.
NPI 1891316147
Obstetrics & Gynecology in Tyler, TX

Active since April 28, 2020PECOS EnrolledAccepts Medicare Assignment
1100 S. BECKHAM, STE. 2200, TYLER, TX 75701(903) 533-8811(903) 593-5511 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 23, 2026, Jun 27, 2024, Jun 14, 2024 and 1 more (4 updates tracked since 2022).

About Kathy Shum Ellington D.o. NPPES

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

KATHY SHUM ELLINGTON D.O. (NPI 1891316147) is an individual obstetrics & gynecology provider in Tyler, Texas, licensed in Texas (V1617) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (2020).

NPPES Registry Identity

NPI1891316147
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameKATHY SHUM ELLINGTONCredential: D.O.
Location Address1100 S. BECKHAM, STE. 2200Tyler, TX 75701
Mailing Address1100 S. Beckham, Ste. 2200Tyler, TX 75701 · (903) 533-8811 · Fax (903) 593-5511
Phone(903) 533-8811
Fax(903) 593-5511
Sole ProprietorNo
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 2020
Enumeration DateApril 28, 2020
Last NPPES UpdateSeptember 23, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2026
✔ NPI 1891316147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in TX · V1617
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1100 S. BECKHAM, Tyler, TX 75701
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Other Names 1

Former Name (1)Kathy Shum Ellington D.o.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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

Kathy Shum Ellington D.o. 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 ID6901229806
PECOS Enrollment IDI20240711004001
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 Kathy Shum Ellington reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Etmc Physician Group Inc.
0.1 mi
Cardiovascular Disease
1000 S BECKHAM AVE
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • 636 clinicians in this Medicare group
NPI 1609382662 (903) 590-5611

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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 12

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

DR. JONATHAN ANDREW EGLY M.D.
Obstetrics & Gynecology
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
ELISE ALEXANDRA ELLIOTT D.O.
Obstetrics & Gynecology
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
DR. SUNNI S. BOREN M.D.
Obstetrics & Gynecology
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
SHEILA RENEE LAYNE DO
Obstetrics & Gynecology
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
AUTUMN WARNOCK
Physician Assistant (Medical)
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
DR. SHERILYN A. WILLIS M.D.
Obstetrics & Gynecology
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
DR. RUSSELL FOREST STANLEY D.O.
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811
MRS. ELIZABETH CROSS ROE P.A.-C
Physician Assistant (Medical)
1100 S. BECKHAM, STE. 2200
TYLER, TX 75701
Smith County (903) 533-8811

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 Kathy Shum Ellington's NPI number?

The NPI number for Kathy Shum Ellington is 1891316147. It was assigned to this individual provider in the NPPES registry on April 28, 2020. The provider is also known as Kathy Shum Ellington D.O..

Where is Kathy Shum Ellington located?

Kathy Shum Ellington practices at 1100 S. Beckham Ste. 2200, Tyler, TX 75701. The listed phone number is (903) 533-8811.

What is Kathy Shum Ellington's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kathy Shum Ellington enrolled in Medicare?

Yes. Kathy Shum Ellington 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 Kathy Shum Ellington's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathy Shum Ellington reassigns Medicare benefits to Etmc Physician Group Inc. (Tyler, 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 Kathy Shum Ellington's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kathy Shum Ellington accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 6 other insurers list Kathy Shum Ellington 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 Kathy Shum Ellington was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days 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.