Individual provider Active NPI

Courtney Gyne Schneidau, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1023318649
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06959 Issued in TX
Practice address
2222 Welborn St
Dallas, TX 75219-3924
Phone
(214) 559-5000
Fax
(214) 443-7309
NPI assigned
Oct 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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 PA06959 TX Primary

Addresses

Primary practice location

2222 Welborn St
Dallas, TX 75219-3924

Mailing address

341 Wheatfield Dr Ste 100
Sunnyvale, TX 75182-4639
Phone (972) 329-1996

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
I20110224000499 TX Practitioner - Physician Assistant 5294916128 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA06959TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Scottish Rite Hospital for Crippled Children CurrentSince May 28, 2019 Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone (469) 857-2222

5700 Dallas Pkwy
Frisco, TX 75034
Phone (469) 515-7100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1023318649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WHEATFIELD DR STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824639",
            "telephone_number": "972-329-1996",
            "fax_number": "972-329-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDAU",
        "first_name": "COURTNEY",
        "middle_name": "GYNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.