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

Q: 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 D.O..

Q: What is Kathy Shum Ellington's specialty?

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

Active since April 28, 2020PECOS Enrolled

2017 RICKETY LN, TYLER, TX 75703(903) 533-8811(903) 593-5511 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2024, Jun 14, 2024, Nov 3, 2022 (3 updates tracked since 2022).

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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 Address2017 RICKETY LNTyler, TX 75703-1706

Mailing Address2017 Rickety LnTyler, TX 75703-1706 · (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 UpdateJune 29, 20263 updates tracked since enumeration

NPPES CertifiedJune 29, 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.

2017 RICKETY LN, Tyler, TX 75703

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Other Names 1

Former Name (1)Kathy Shum D.o.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathy Shum Ellington D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75703 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 9

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

ELISE ALEXANDRA ELLIOTT D.O.

Obstetrics & Gynecology