Keith Pensom, DO - Medicare Emergency Medicine in Fort Worth, TX

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Keith Pensom, DO is a medicare enrolled "Family Medicine" physician in Fort Worth, Texas. He graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Small Hospital Innovations, Angelina Emergency Medicine Associates Pa, Port Arthur Emergency Physicians and his current practice location is 544 W Seminary Dr, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 924-7978.

Keith Pensom is licensed to practice in Texas (license number K9387) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1689878761.

Contact Information

Keith Pensom, DO
544 W Seminary Dr,
Fort Worth, TX 76115-1360
(817) 924-7978
Not Available

Map and Direction




Physician's Profile

Full NameKeith Pensom
GenderMale
SpecialityEmergency Medicine
Experience28 Years
Location544 W Seminary Dr, Fort Worth, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Keith Pensom graduated from medical school in 1996
  NPI Data:
  • NPI Number: 1689878761
  • Provider Enumeration Date: 06/13/2007
  • Last Update Date: 08/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8022901404
  • Enrollment ID: I20040209000140

Medical Identifiers

Medical identifiers for Keith Pensom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689878761NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine K9387 (Texas)Secondary
207Q00000XFamily Medicine K9387 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
The Medical Center Of Southeast TexasPort arthur, TXHospital
Woodland Heights Medical CenterLufkin, TXHospital
Kell West Regional HospitalWichita falls, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Small Hospital Innovations084041544458
Angelina Emergency Medicine Associates Pa539597356413
Port Arthur Emergency Physicians690190573613

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keith Pensom allows following entities to bill medicare on his behalf.
Entity NameTitanium Emergency Group Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023075462
PECOS PAC ID: 4486639705
Enrollment ID: O20040622001653
Entity NameAcs Primary Care Physicians Southwest Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538101019
PECOS PAC ID: 1850204363
Enrollment ID: O20041206000027
Entity NameConcord Medical Group Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083630610
PECOS PAC ID: 0446296818
Enrollment ID: O20050707000531
Entity NamePort Arthur Emergency Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255491627
PECOS PAC ID: 6901905736
Enrollment ID: O20070620000245
Entity NameAngelina Emergency Medicine Associates Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518397298
PECOS PAC ID: 5395973564
Enrollment ID: O20140115000579
Entity NameConcord Medical Group Of Texas Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750790762
PECOS PAC ID: 7810117223
Enrollment ID: O20141007002567
Entity NameEmergency Services Of Texas Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174932131
PECOS PAC ID: 7517289291
Enrollment ID: O20141208002099
Entity NameLonghorn Emergency Medical Associates Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649669672
PECOS PAC ID: 4486971041
Enrollment ID: O20150320000152
Entity NameEss Of South Texas Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295128247
PECOS PAC ID: 9739491176
Enrollment ID: O20150629000248
Entity NameLucy Park Emergency Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023560133
PECOS PAC ID: 8527349083
Enrollment ID: O20161222000048
Entity NameSmall Hospital Innovations
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184040560
PECOS PAC ID: 0840415444
Enrollment ID: O20220124000512

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith Pensom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Keith Pensom, DO
544 W Seminary Dr,
Fort Worth, TX 76115-1360

Ph: (817) 924-7978		Keith Pensom, DO
544 W Seminary Dr,
Fort Worth, TX 76115-1360

Ph: (817) 924-7978

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.