Individual provider Active NPI

Jorge Corona, MD

  • Psychiatry Physician
  • Southlake, TX
National Provider Identifier
1235636671
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
T0758 Issued in TX
Practice address
420 N Carroll Ave Ste 150
Southlake, TX 76092-6454
Phone
(210) 941-2258
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X T0758 TX Primary

Addresses

Primary practice location

420 N Carroll Ave Ste 150
Southlake, TX 76092-6454

Mailing address

209 S Shady Shores Dr # 300-177
Lake Dallas, TX 75065-2973
Phone (214) 536-0873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220817002464 TX Practitioner - Psychiatry 4981087350 Reassigns benefits to 3 organizations
I20221004001222 NY Practitioner - Psychiatry 4981087350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fuqua Psychiatric Consulting PLLCGroup PAC ID 9830540962, 4 clinicians

Practice addresses (Care Compare)

8000 W Ih
10 Suite 1500
San Antonio, TX 78230-3883
Phone (210) 201-2241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T0758TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Fuqua Psychiatric Consulting, PLLC Psychiatry CurrentSince Nov 1, 2025 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Sep 30, 2022 Accepting new patients

Locations

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

1400 N Coit Rd
Ste 302
McKinney, TX 75071
Phone (214) 504-3005

Organizations & group practices 3

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1235636671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S SHADY SHORES DR # 300-177",
            "city": "LAKE DALLAS",
            "state": "TX",
            "postal_code": "750652973",
            "telephone_number": "214-536-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N CARROLL AVE STE 150",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926454",
            "telephone_number": "210-941-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONA",
        "first_name": "JORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "T0758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.