Individual provider Active NPI

Sean Charles Holt, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1265695332
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06404 Issued in TX
Practice address
5201 Harry Hines Blvd - Surgical Services
Dallas, TX 75266-0599
Phone
(214) 590-8640
NPI assigned
Jul 8, 2008
Last updated
Jul 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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 PA06404 TX Primary
Surgical Physician Assistant 363AS0400X NU

Addresses

Primary practice location

5201 Harry Hines Blvd - Surgical Services
Dallas, TX 75266-0599

Mailing address

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-8640

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
I20100608000098 TX Practitioner - Physician Assistant 1850421512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total MD Physicians Group, PLLCGroup PAC ID 7012313521, 127 clinicians

Practice addresses (Care Compare)

2014 W University Dr
Suite 330
McKinney, TX 75071-2228
Phone (972) 645-5107

234 W Campbell Rd
Richardson, TX 75080-3512
Phone (972) 474-3221

6150 Eldorado Pkwy
Suite 140
McKinney, TX 75070-5702
Phone (972) 645-2077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WLS Surgical Associates PA Past Accepting new patients
Dallas County Hospital District Past Accepting new patients
Vickery Health Center Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1265695332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD - SURGICAL SERVICES",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599",
            "telephone_number": "214-590-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "SEAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06404",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.