Individual provider Active NPI

Nikolas Mendrygal, MD

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1063455905
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M3017 Issued in TX
Practice address
7777 Forest Lane
Dallas, TX 75230
Phone
(972) 248-3017
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M3017 TX Primary

Addresses

Primary practice location

7777 Forest Lane
Dallas, TX 75230

Mailing address

12221 Merit Drive
Ste 1610
Dallas, TX 75251
Phone (214) 217-1911

Other identifiers 4

IdentifierTypeStateIssuer
184396301MedicaidTX
8V3528OtherTXBCBS
184396302MedicaidTX
P00386322OtherTXRAILROAD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070222000520 TX Practitioner - Emergency Medicine 1153423108 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M3017TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Medical Services PLLC Emergency Medicine CurrentSince Apr 1, 2014 Accepting new patients
Questcare Medical Services, PLLC Emergency Medicine CurrentSince Apr 1, 2014 Accepting new patients
Questcare Medical Services, PLLC Emergency Medicine Current Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

13172 Highway 287
Haslet, TX 76052
Phone (682) 703-4410

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1063455905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 MERIT DRIVE",
            "address_2": "STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75251",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-248-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDRYGAL",
        "first_name": "NIKOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M3017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184396301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V3528",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184396302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00386322",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.