NPIMap

Individual provider Active NPI

Micah Van Yperen, PA-C

  • Medical Physician Assistant
  • Dallas, TX
National Provider Identifier
1053161364
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17880 Issued in TX
Practice address
6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone
(214) 633-5555
NPI assigned
Mar 27, 2024
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17880 TX Primary

Addresses

Primary practice location

6201 Harry Hines Blvd
Dallas, TX 75235-5202

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 633-5555

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
I20241114002689 TX Practitioner - Physician Assistant 7012441991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Universal Surgical Assistants Inc.Group PAC ID 8224290499, 7 clinicians

Practice addresses (Care Compare)

1 Sugar Creek Ctr Blvd
Suite 618
Sugar Land, TX 77478-3540
Phone (832) 655-4141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17880TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Surgical Associates LLP Multi-Specialty CurrentSince Mar 31, 2024 Accepting new patients

Locations

17510 W Grand Pkwy S
Ste 490
Sugar Land, TX 77479

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.

Hospital & facility affiliations 9

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": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1053161364",
    "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",
            "telephone_number": "214-633-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355202",
            "telephone_number": "214-633-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN YPEREN",
        "first_name": "MICAH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA17880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.