Mark Lee Nentwig, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13531 Issued in TX

Practice address

6411 E Northwest Hwy Ste 120
Dallas, TX 75231-8007

Phone

(469) 495-9110

NPI assigned

Apr 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Urgent CareGroup PAC ID 0345654414, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mnentwig2551566@direct.texashealth.org

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.

• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Arlington, TX
  • NPI 1952915365

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Primamed Physicians PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1164494068
  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412
  Medicare reassignment
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1104431527
  NPD
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Allen, TX
  • NPI 1629724315
  NPD
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • McKinney, TX
  • NPI 1972118388
  NPD
• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1154472967
  NPD
• Citimed, P.a.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1487823316
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1134758964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 E NORTHWEST HWY STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752318007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 E NORTHWEST HWY STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752318007",
            "telephone_number": "469-495-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NENTWIG",
        "first_name": "MARK",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnentwig2551566@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6411 E Northwest Hwy Ste 120",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752318007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnentwig2551566@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6411 E Northwest Hwy Ste 120",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752318007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.

Verify at the official NPI Registry.