Active NPI
Jonathan J Dora, M.D.
- Plastic Surgery Physician
- Houston, TX
National Provider Identifier
1124195656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- D4977
- Practice address
- 6560 Fannin St
Suite 760
Houston, TX 77030-2761 - Phone
- (713) 790-0024
- Fax
- (713) 790-9767
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | D4977 | TX | Primary |
Addresses
Primary practice location
6560 Fannin St
Suite 760
Houston, TX 77030-2761
Mailing address
PO Box 540363
Houston, TX 77254-0363
Phone (713) 790-0024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D4977 | Other | TX | LICENSE NUMBER |
| 741949173 | Other | TX | TAX IDENTIFICATION NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark H. Edelman M.D., P.a. | Past | Accepting new patients |
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.
-
- Plastic and Reconstructive Surgery Physician
- Houston, TX
- NPI 1932402617
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1124195656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 540363",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772540363",
"telephone_number": "713-790-0024",
"fax_number": "713-790-9767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6560 FANNIN ST",
"address_2": "SUITE 760",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302761",
"telephone_number": "713-790-0024",
"fax_number": "713-790-9767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORA",
"first_name": "JONATHAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TX",
"license": "D4977",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "D4977",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "741949173",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.