Individual provider Active NPI

Kathryn Velin Ives, PA-C

  • Physician Assistant
  • Garland, TX
National Provider Identifier
1053876151
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12404 Issued in TX
Practice address
7217 Telecom Pkwy Ste 100
Garland, TX 75044-2203
Phone
(469) 800-2100
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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 PA12404 TX Primary

Addresses

Primary practice location

7217 Telecom Pkwy Ste 100
Garland, TX 75044-2203

Mailing address

4001 Ross Ave Apt 223
Dallas, TX 75204-5206
Phone (214) 280-6704

Other names 1

  • Kathryn Velin McMahan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kives450112@direct.sw.org

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
I20190308000414 TX Practitioner - Physician Assistant 4284973207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

7217 Telecom Pkwy
Garland, TX 75044-2203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA12404TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Mar 18, 2019 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

7217 Telecom Pkwy
Ste 100
Garland, TX 75044
Phone (469) 669-0306

Interoperability endpoints

  • Direct secure messaging: kives450112@direct.sw.org

Organizations & group practices 3

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1053876151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 ROSS AVE APT 223",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752045206",
            "telephone_number": "214-280-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 TELECOM PKWY STE 100",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442203",
            "telephone_number": "469-800-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "KATHRYN",
        "middle_name": "VELIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kives450112@direct.sw.org",
            "affiliation": "N",
            "address_1": "7217 Telecom Pkwy Ste 100",
            "city": "Garland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750442203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MCMAHAN",
            "middle_name": "VELIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.