Individual provider Active NPI

Bryson Oneil, PA-C

  • Physician Assistant
  • Flower Mound, TX
National Provider Identifier
1114376852
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16221 Issued in TX
Practice address
4001 Long Prairie Rd Ste 145
Flower Mound, TX 75028-1528
Phone
(469) 654-7570
NPI assigned
Jun 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16221 TX Primary

Addresses

Primary practice location

4001 Long Prairie Rd Ste 145
Flower Mound, TX 75028-1528

Mailing address

5310 Harvest Hill Rd Ste 290
Dallas, TX 75230-5826
Phone (214) 420-0650

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
I20221202001241 TX Practitioner - Physician Assistant 9739472564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

2321 Ira E Woods Ave
180 U.S. Dermatology Partners
Grapevine, TX 76051-8632
Phone (817) 329-2263

4921 Long Prairie Rd
Suite 110
Flower Mound, TX 75028-2742
Phone (469) 931-0944

9808 N Beach St
Suite 600
Fort Worth, TX 76244-6184
Phone (817) 741-7515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16221TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center Past Accepting new patients
Dermatology Associates Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1114376852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD STE 145",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281528",
            "telephone_number": "469-654-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEIL",
        "first_name": "BRYSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.