Individual provider Active NPI

Manjit Kaur, FNP

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1073205928
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1031065 Issued in TX
Practice address
1 Medical Pkwy Ste 103
Dallas, TX 75234-7830
Phone
(972) 247-5464
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1031065 TX
Family Nurse Practitioner 363LF0000X 1031065 TX Primary

Addresses

Primary practice location

1 Medical Pkwy Ste 103
Dallas, TX 75234-7830

Mailing address

PO Box 661247
Dallas, TX 75266-1247

Other practice location 1

555 Republic Dr Ste 100
Plano, TX 75074-5400
Phone (903) 364-8702

Other practice location 2

4812 Roberts St
Greenville, TX 75401-5669
Phone (903) 455-1234

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
I20230907001762 TX Practitioner - Nurse Practitioner 1456715630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Medical Physician GroupGroup PAC ID 7517194491, 17 clinicians

Practice addresses (Care Compare)

1 Medical Pkwy
Suite 103
Dallas, TX 75234-7830
Phone (972) 488-9656

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1031065TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Medical Physician Group Family CurrentSince Dec 16, 2024 Accepting new patients
Dallas Medical Physician Group CurrentSince Dec 16, 2024 Accepting new patients

Locations

1 Medical Pkwy
Ste 103
Dallas, TX 75234
Phone (972) 488-9656

5308 N Galloway Ave
Mesquite, TX 75150
Phone (972) 226-0505

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1073205928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661247",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752661247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PKWY STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347830",
            "telephone_number": "972-247-5464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Republic Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750745400",
            "country_code": "US",
            "telephone_number": "903-364-8702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4812 Roberts St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754015669",
            "country_code": "US",
            "telephone_number": "903-455-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "MANJIT",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1031065",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.