NPIMap

Individual provider Active NPI

Eric Manthuruthil, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1255790796
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10504 Issued in TX
Practice address
5939 Harry Hines Blvd
Dallas, TX 75390
Phone
(214) 645-2100
NPI assigned
Feb 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X PA10504 TX Primary

Addresses

Primary practice location

5939 Harry Hines Blvd
Dallas, TX 75390

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (817) 707-5636

Other practice location 1

207 Enchanted Ct
Grand Prairie, TX 75050-8064
Phone (817) 707-5636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160606001785 TX Practitioner - Physician Assistant 1557651460 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Legacy Urgent Care PAGroup PAC ID 3072679828, 157 clinicians
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1310 W Exchange Pkwy
Suite 100
Allen, TX 75013-7025
Phone (972) 678-4545

2021 N Macarthur Boulevard
Irving, TX 75061-2210

4001 Worth St
Dallas, TX 75246-1608

5800 E Lovers LN
Dallas, TX 75206-2901
Phone (972) 817-6260

9205 Legacy Dr
Frisco, TX 75033-6750
Phone (972) 625-6020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 17, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 13, 2025 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Oct 13, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 17, 2018 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

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

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

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

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

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: emanthuruthil1485251@direct.sw.org

Organizations & group practices 7

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 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1255790796",
    "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": "752847208",
            "telephone_number": "817-707-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-645-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Enchanted Ct",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750508064",
            "country_code": "US",
            "telephone_number": "817-707-5636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTHURUTHIL",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-12",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.