Active NPI
Samuel Anene, PA-C
- Physician Assistant
- Dallas, TX
National Provider Identifier
1093685299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA19956
- Practice address
- 1411 N Beckley Ave Ste 352
Dallas, TX 75203-1270 - Phone
- (469) 981-2648
- Fax
- (469) 981-2649
- NPI assigned
- Nov 11, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19956 | TX | Primary |
Addresses
Primary practice location
1411 N Beckley Ave Ste 352
Dallas, TX 75203-1270
Mailing address
1411 N Beckley Ave Ste 352
Dallas, TX 75203-1270
Phone (469) 981-2648
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260424001363 | TX | Practitioner - Physician Assistant | 2163999343 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1411 N Beckley Ave
Suite 352
Dallas, TX 75203-1270
PO Box
Suite 2736
Desoto, TX 75123
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA19956 | TX | MD | Physician Assistant |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HJGHCD/Endpoint/HJGHCD
Organizations & group practices 1
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": "1762819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1093685299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 N BECKLEY AVE STE 352",
"city": "DALLAS",
"state": "TX",
"postal_code": "752031270",
"telephone_number": "469-981-2648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 N BECKLEY AVE STE 352",
"city": "DALLAS",
"state": "TX",
"postal_code": "752031270",
"telephone_number": "469-981-2648",
"fax_number": "469-981-2649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANENE",
"first_name": "SAMUEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-11",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA19956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
- Nikole Christine Andries, CRNA
- Estefania Lopez Andrioaia, RD, LD, CDE
- Kristin M. Andruska, P.A.
- Andy Medical Equipment Inc
- Nida Anees
- Anesthesia Alliance of Dallas, P.a.
- Anesthesia by GM, P.a.
- Anesthesia Consultants of Dallas LLP
- Anesthesia Consultants of Dallas, LLP
- Anesthesia Consultants of Dallas, LLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.