Individual provider Active NPI

Sophia Katherine Lange, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1215509468
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15382 Issued in TX
Practice address
411 N Washington Ave Ste 7000
Dallas, TX 75246-1791
Phone
(214) 826-3681
Fax
(214) 826-7277
NPI assigned
Jul 15, 2021
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15382 TX Primary
Otolaryngology Physician 207Y00000X PA15382 TX
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X PA15832 TX

Addresses

Primary practice location

411 N Washington Ave Ste 7000
Dallas, TX 75246-1791

Mailing address

411 N Washington Ave Ste 7000
Dallas, TX 75246-1791
Phone (214) 826-3681

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
I20221102000716 TX Practitioner - Physician Assistant 2466850276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialty Care PLLCGroup PAC ID 5193770873, 8 clinicians

Practice addresses (Care Compare)

411 N Washington Ave
Suite 7000
Dallas, TX 75246-1791
Phone (214) 826-3681

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15382TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Texas Billing, Inc. PastSince Oct 1, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1215509468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 7000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461791",
            "telephone_number": "214-826-3681",
            "fax_number": "214-826-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 7000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461791",
            "telephone_number": "214-826-3681",
            "fax_number": "214-826-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "SOPHIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15382",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "PA15382",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "PA15832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.