Individual provider Active NPI

Joshua Nackenson

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1033573498
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R4604 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390
Phone
(214) 590-8000
NPI assigned
Apr 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X R4604 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180531000379 TX Practitioner - Emergency Medicine 9133484769 Reassigns benefits to 3 organizations
I20200825002659 CA Practitioner - Emergency Medicine 9133484769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates Fremont PCGroup PAC ID 8527303585, 32 clinicians
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Associates Fremont PC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Concord North Texas, PLLC Emergency Medicine CurrentSince Jul 25, 2018 Accepting new patients
County of Santa Clara CurrentSince Oct 6, 2020 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2019 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Apr 5, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Emergency Medicine CurrentSince Oct 6, 2020 Accepting new patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Apr 5, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

9400 No Name Uno
Gilroy, CA 95020
Phone (408) 848-2000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

504 Lipscomb St
Bonham, TX 75418
Phone (903) 583-8585

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: jnackenson157874@santaclaravalley.direct-ci.net

Organizations & group practices 11

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1033573498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-590-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKENSON",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R4604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.