Individual provider Active NPI

Adrian Adan, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1033826847
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18144 Issued in TX
Practice address
4835 LBJ Fwy Ste 900
Dallas, TX 75244-6001
Phone
(469) 420-5544
NPI assigned
Nov 1, 2022
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10553 AZ
Physician Assistant 363A00000X PA18144 TX Primary

Addresses

Primary practice location

4835 LBJ Fwy Ste 900
Dallas, TX 75244-6001

Mailing address

2323 N Central Expy
Richardson, TX 75080-2712
Phone (214) 453-4533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240820001722 TX Practitioner - Physician Assistant 5193263218 Reassigns benefits to 1 organization
I20250207002569 AZ Practitioner - Physician Assistant 5193263218 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services PC Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Emergency Professional Services PC Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

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, 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": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1033826847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 N CENTRAL EXPY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802712",
            "telephone_number": "214-453-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 LBJ FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752446001",
            "telephone_number": "469-420-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAN",
        "first_name": "ADRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-01",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10553",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.