Individual provider Active NPI

Idania Sirleny Hidalgo, M.D.

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1154701142
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R3861 Issued in TX
Practice address
820 S Carrier Pkwy
Grand Prairie, TX 75051
Phone
(972) 262-1425
Fax
(972) 237-4973
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10053768 TX
Family Medicine Physician 207Q00000X R3861 TX Primary

Addresses

Primary practice location

820 S Carrier Pkwy
Grand Prairie, TX 75051

Mailing address

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone (972) 262-1425

Other practice location 1

1402 W Avenue H
Temple, TX 76504-5342
Phone (254) 771-8401

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
I20180205001179 TX Practitioner - Family Practice 5294016614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

3000 Blackburn St
Suite 130
Dallas, TX 75204-2217
Phone (214) 599-8624

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone (972) 262-1425

Hospital & facility affiliations

  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
  • Medical City Arlington Hospital, Arlington, TX, CCN 450675
  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth Family Medicine Current Accepting new patients
Medhealth CurrentSince Aug 6, 2018 Accepting new patients

Locations

820 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (972) 262-1425

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

Interoperability endpoints

  • Direct secure messaging: ihildago88262@dm.mhd.com

Organizations & group practices 2

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 3

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1154701142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511517",
            "telephone_number": "972-262-1425",
            "fax_number": "972-237-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-262-1425",
            "fax_number": "972-237-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 W Avenue H",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765045342",
            "country_code": "US",
            "telephone_number": "254-771-8401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "IDANIA",
        "middle_name": "SIRLENY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10053768",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R3861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.