Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ubong Raymond Atiata

Individual provider Physician Assistant · NPI 1801541578

Mr. Ubong Raymond Atiata is a Physician Assistant in Shenandoah, Texas. Qualified in 2022, 4 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
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Practice location Address checks out

17189 Interstate 45 S Ste 475
Shenandoah, TX 77385-3320
Phone: (936) 270-3933
Fax: (713) 791-5134
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 425 W Grand Ave Ste 2002, Dayton, OH 45405-4769 — (937) 294-3611
  • 3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 — (937) 294-3611

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA16593 (TX)

Record details

NPI number1801541578
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 21, 2022
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Shenandoah