Individual provider Active NPI

Michael Anthony Taylor, PA-C

  • Physician Assistant
  • Midland, TX
National Provider Identifier
1023121241
Registry record updated Apr 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 04202 Issued in TX
Practice address
4304 Andrews Hwy
Midland, TX 79703-4824
Phone
(432) 520-3020
Fax
(432) 699-1981
NPI assigned
Aug 15, 2006
Last updated
Apr 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 04202 TX Primary

Addresses

Primary practice location

4304 Andrews Hwy
Midland, TX 79703-4824

Mailing address

4304 Andrews Hwy
Midland, TX 79703-4824
Phone (432) 520-3020

Other identifiers 2

IdentifierTypeStateIssuer
8758NHOtherTXBCBS
P01301129OtherTXMEDICARE RR

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
I20080916000466 TX Practitioner - Physician Assistant 9931275880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 04202TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Texas Orthopedic Group Inc Past Accepting new patients
West Texas Orthopedics LLP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.taylor.1@9682.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585958400000",
    "number": "1023121241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 ANDREWS HWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034824",
            "telephone_number": "432-520-3020",
            "fax_number": "432-699-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 ANDREWS HWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034824",
            "telephone_number": "432-520-3020",
            "fax_number": "432-699-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA 04202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8758NH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01301129",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.