Individual provider Active NPI

Bruce Edward Mickey, MD

  • Neurological Surgery Physician
  • Dallas, TX
National Provider Identifier
1144289273
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
F1821 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 645-2300
Fax
(214) 645-2301
NPI assigned
Mar 18, 2006
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X F1821 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-2300

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000768 TX Practitioner - Neurosurgery 1153465315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Texas Southwestern Medical School at Dallas, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Suite 920
Dallas, TX 75246-2035
Phone (469) 800-9260

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 8, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 16, 1984 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Neurological Surgery CurrentSince Jul 16, 1984 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 8, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

3417 Gaston Ave
Ste 920
Dallas, TX 75246
Phone (469) 800-9260

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: bmickey460212@direct.sw.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1144289273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-2300",
            "fax_number": "214-645-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-2300",
            "fax_number": "214-645-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKEY",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "F1821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.