Individual provider Active NPI

Kevin Jack Shih, MD

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1063806107
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R4636 Issued in TX
Practice address
4682 McDermott Rd Ste 100
Plano, TX 75024-7772
Phone
(972) 596-6400
Fax
(972) 867-4766
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R4636 TX Primary

Addresses

Primary practice location

4682 McDermott Rd Ste 100
Plano, TX 75024-7772

Mailing address

4682 McDermott Rd Ste 100
Plano, TX 75024-7772
Phone (972) 596-6400

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
I20190918002204 TX Practitioner - Internal Medicine 4284964255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Clinic of North Texas, PLLCGroup PAC ID 9830084540, 212 clinicians

Practice addresses (Care Compare)

6161 N State Hwy 161
Irving, TX 75038-2220
Phone (972) 258-7499

7501 Lakeview Pkwy
Suite 130
Rowlett, TX 75088-9324
Phone (972) 463-3100

900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000

Hospital & facility affiliations

  • Baylor Scott & White Medical Center at Irving Hospital, Irving, TX, CCN 450079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC CurrentSince Jan 12, 2025 Accepting new patients
Medical Clinic of North Texas, PLLC Internal Medicine CurrentSince Jan 12, 2025 Accepting new patients
Wellmed Medical Group, P.a. Internal Medicine CurrentSince Jul 22, 2019 Accepting new patients
Wellmed Medical Group, PA Internal Medicine CurrentSince Jul 22, 2019 Accepting new patients

Locations

6750 N MacArthur Blvd
Ste 350
Irving, TX 75039
Phone (972) 556-1616

6161 State Highway 161
Ste 200
Irving, TX 75038
Phone (972) 257-7499

4682 McDermott Rd
#100
Plano, TX 75024
Phone (972) 596-6400

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: kevin.shih@wellmed.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1063806107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "KEVIN",
        "middle_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R4636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.