Individual provider Active NPI

Olivia Masonheimer, PA

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1194560391
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18136 Issued in TX
Practice address
4601 Old Shepard PL Ste 101
Plano, TX 75093-5251
Phone
(214) 919-2350
Fax
(214) 919-2361
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18136 TX Primary

Addresses

Primary practice location

4601 Old Shepard PL Ste 101
Plano, TX 75093-5251

Mailing address

1308 Thompson Rd
Argyle, TX 76226-3454
Phone (678) 727-3348

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726003252 TX Practitioner - Physician Assistant 6901342864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louis a Torres Jr MD PLLCGroup PAC ID 5597911610, 2 clinicians

Practice addresses (Care Compare)

4601 Old Shepard PL
Suite 101
Plano, TX 75093-5251
Phone (214) 919-2350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18136TXMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCJAED/Endpoint/HCJAED

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.

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1194560391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 THOMPSON RD",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762263454",
            "telephone_number": "678-727-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 OLD SHEPARD PL STE 101",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935251",
            "telephone_number": "214-919-2350",
            "fax_number": "214-919-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASONHEIMER",
        "first_name": "OLIVIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.