NPIMap

Individual provider Active NPI

Michael G McInnis, MD

  • Internal Medicine Physician
  • Mansfield, TX
National Provider Identifier
1033189956
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L5834 Issued in TX
Practice address
252 Matlock Rd
Suite 130
Mansfield, TX 76063-6413
Phone
(817) 473-7184
Fax
(817) 473-7186
NPI assigned
Jan 24, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L5834 TX Primary

Addresses

Primary practice location

252 Matlock Rd
Suite 130
Mansfield, TX 76063-6413

Mailing address

252 Matlock Rd
Suite 130
Mansfield, TX 76063-6413
Phone (817) 473-7184

Other identifiers 1

IdentifierTypeStateIssuer
159747801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090824000250 TX Practitioner - Internal Medicine 3375697667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

252 Matlock Rd
Suite 130
Mansfield, TX 76063-4295
Phone (817) 473-7184

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5834TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince May 1, 2017 Accepting new patients
Medhealth Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Arlington Physicians PA Internal Medicine Past Accepting new patients
Arlington Physicians, P.a. Internal Medicine Past Accepting new patients
Vesta Solutions Group, LLC Past Accepting new patients

Locations

4560 Lake Ridge Pkwy
Ste 200
Grand Prairie, TX 75052
Phone (972) 263-5272

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

252 Matlock Rd
Ste 130
Mansfield, TX 76063
Phone (682) 242-8990

Interoperability endpoints

  • Direct secure messaging: mmcinnis51411@dm.mhd.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033189956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD",
            "address_2": "SUITE 130",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636413",
            "telephone_number": "817-473-7184",
            "fax_number": "817-473-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD",
            "address_2": "SUITE 130",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636413",
            "telephone_number": "817-473-7184",
            "fax_number": "817-473-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L5834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159747801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.