Individual provider Active NPI

Daragh Heitzman, M.D.

  • Neurology Physician
  • Dallas, TX
National Provider Identifier
1023083961
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
H8118 Issued in TX
Practice address
6080 N Central Expy Ste 100
Dallas, TX 75206-5202
Phone
(214) 827-3610
Fax
(214) 821-4017
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X H8118 TX Primary

Addresses

Primary practice location

6080 N Central Expy Ste 100
Dallas, TX 75206-5202

Mailing address

6080 N Central Expy Ste 100
Dallas, TX 75206-5202
Phone (214) 827-3610

Other identifiers 1

IdentifierTypeStateIssuer
127516605MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000740 TX Practitioner - Neurology 4183681521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Texas Tech University Health Science Center School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Neurology PAGroup PAC ID 2860476397, 13 clinicians

Practice addresses (Care Compare)

6080 N Central Expy
Suite 100
Dallas, TX 75206-5202
Phone (214) 827-3610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8118TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Center at Texas Neurology CurrentSince Jan 9, 1991 Accepting new patients
Texas Neurology, P.a. Current Accepting new patients
Texas Neurology, P.a. Neurology CurrentSince Jan 9, 1991 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

6080 N Central Expy
Ste 100
Dallas, TX 75206
Phone (214) 827-3610

6301 Gaston Ave
Ste 400W
Dallas, TX 75214
Phone (214) 827-3610

6301 Gaston Ave
Ste 100W
Dallas, TX 75214
Phone (214) 827-3610

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBAABA/Endpoint/BBAABA
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBAABA

Organizations & group practices 4

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 4

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1023083961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 N CENTRAL EXPY STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065202",
            "telephone_number": "214-827-3610",
            "fax_number": "214-821-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 N CENTRAL EXPY STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065202",
            "telephone_number": "214-827-3610",
            "fax_number": "214-821-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "DARAGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "H8118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127516605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.