Individual provider Active NPI

Jonathan Nathan, M.D.

  • Plastic Surgery Physician
  • Dallas, TX
National Provider Identifier
1134449374
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
T0295 Issued in TX
Practice address
3900 Junius St Ste 605
Dallas, TX 75246-1630
Phone
(214) 814-1711
Fax
(214) 292-8709
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X T0295 TX Primary

Addresses

Primary practice location

3900 Junius St Ste 605
Dallas, TX 75246-1630

Mailing address

3900 Junius St Ste 605
Dallas, TX 75246-1630
Phone (214) 814-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190820004070 IL Practitioner - DermatologyPractitioner - Plastic and Reconstructive Surgery 1658674320
I20210429000984 TX Practitioner - Plastic and Reconstructive Surgery 1658674320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Dermatology ,PLLCGroup PAC ID 9032492822, 8 clinicians

Practice addresses (Care Compare)

3140 Legacy Dr
Suite 110
Frisco, TX 75034-7917
Phone (972) 469-2626

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Uptown Hospital, Dallas, TX, CCN 450422
  • Baylor Scott & White Medical Center - Frisco Hospital, Frisco, TX, CCN 450853

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision35
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology, PA CurrentSince Dec 1, 2021 Accepting new patients
Jonathan Nathan MD Mba PLLC Current Accepting new patients
Legacy Dermatology, PLLC CurrentSince Jun 29, 2024 Accepting new patients
Westlake Dermatology PA Plastic Surgery Current Accepting new patients
Westlake Dermatology, PA CurrentSince Dec 1, 2021 Accepting new patients
Pediatric Dermatology of No. TX Past Accepting new patients
Mark a Codner MD LLC Plastic Surgery Past Accepting new patients
Atlanta Plastic & Reconstructive Specialists, LLC Plastic Surgery Past Accepting new patients
Pinnacle Dermatology, SC Plastic Surgery Past Accepting new patients

Locations

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

6565 Hillcrest Ave
Ste 110
Dallas, TX 75205
Phone (972) 512-4800

6565 Hillcrest Ave
Dallas, TX 75205
Phone (972) 512-4800

3900 Junius St
Ste 605
Dallas, TX 75246
Phone (214) 814-1711

3140 Legacy Dr
Ste 110
Frisco, TX 75034
Phone (972) 469-2626

Interoperability endpoints

  • Direct secure messaging: drnathan@westlake.emadirect.md
  • Direct secure messaging: jnathan@legacydermatology.emadirect.md

Organizations & group practices 9

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 2

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1134449374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461630",
            "telephone_number": "214-814-1711",
            "fax_number": "214-292-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461630",
            "telephone_number": "214-814-1711",
            "fax_number": "214-292-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "T0295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.