NPIMap

Individual provider Active NPI

John A Mohnickey, PA

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1073587705
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03349 Issued in TX
Practice address
3014 N O Connor Rd
Ste 110
Irving, TX 75062-4415
Phone
(469) 277-8255
Fax
(866) 509-8481
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X S0000670 OH
Physician Assistant 363A00000X PA03349 TX Primary

Addresses

Primary practice location

3014 N O Connor Rd
Ste 110
Irving, TX 75062-4415

Mailing address

2805 Dallas Pkwy
Ste 640
Plano, TX 75093-8719
Phone (469) 277-8255

Other identifiers 4

IdentifierTypeStateIssuer
2513051MedicaidOH
212093301MedicaidTX
212093303MedicaidTX
212093302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA03349TXMDPhysician Assistant
S0000670OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients
Doctx3 PLLC Past Accepting new patients
Doctx3 PLLC Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients
Medhealth Past Accepting new patients

Organizations & group practices 5

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1073587705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 DALLAS PKWY",
            "address_2": "STE 640",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938719",
            "telephone_number": "469-277-8255",
            "fax_number": "866-509-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 N O CONNOR RD",
            "address_2": "STE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624415",
            "telephone_number": "469-277-8255",
            "fax_number": "866-509-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHNICKEY",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "S0000670",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2513051",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212093301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212093303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212093302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.