Individual provider Active NPI

Marlen Vanessa Piersall, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1003365602
Registry record updated May 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12506 Issued in TX
Practice address
1801 Inwood Rd
Dallas, TX 75235-7202
Phone
(214) 654-2900
NPI assigned
Sep 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20160088 NM
Physician Assistant 363A00000X PA12506 TX Primary

Addresses

Primary practice location

1801 Inwood Rd
Dallas, TX 75235-7202

Mailing address

1801 Inwood Rd
Dallas, TX 75235-7202

Other names 1

  • Marlen Vanessa Maldonado Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610002779 TX Practitioner - Physician Assistant 7315220894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

12400 Dallas Pkwy
Frisco, TX 75033-4224
Phone (469) 604-9000

1801 Inwood Rd
Dallas, TX 75235-7202

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-2700

3621 22ND St
Suite 400
Lubbock, TX 79410-1302
Phone (806) 791-8484

5939 Harry Hines Blvd
Dallas, TX 75390-0001
Phone (214) 645-0624

6202 Harry Hines Blvd
Dallas, TX 75390-0001
Phone (214) 645-4673

6303 Harry Hines
Suite 302
Dallas, TX 75390-0001
Phone (214) 645-0624

Hospital & facility affiliations

  • Texas Health Hospital Frisco Hospital, Frisco, TX, CCN 670260
  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20160088NMMDPhysician Assistant
PA12506TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 15, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 15, 2019 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

1801 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2035

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1003365602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 INWOOD RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 INWOOD RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357202",
            "telephone_number": "214-654-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSALL",
        "first_name": "MARLEN",
        "middle_name": "VANESSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2024-05-12",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA20160088",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLEN",
            "last_name": "MALDONADO",
            "middle_name": "VANESSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.