Individual provider Active NPI

Mary Gajewski Ashmead, MD

  • Otolaryngology Physician
  • Southlake, TX
National Provider Identifier
1275769754
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
Q3637 Issued in TX
Practice address
300 S Nolen Dr Ste 100
Southlake, TX 76092-8057
Phone
(817) 989-2400
Fax
(817) 549-8463
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 20090067 MS
Otolaryngology Physician 207Y00000X Q3637 TX Primary

Addresses

Primary practice location

300 S Nolen Dr Ste 100
Southlake, TX 76092-8057

Mailing address

5220 W University Dr Ste 150
McKinney, TX 75071-7418
Phone (972) 984-1050

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728004254 TX Practitioner - Otolaryngology 8123245461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The ENT and Allergy Centers of Texas, PLLCGroup PAC ID 4385709054, 56 clinicians

Practice addresses (Care Compare)

5220 W University Dr
Suite 150
McKinney, TX 75071-7418
Phone (972) 984-1050

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20090067MSMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The ENT & Allergy Centers of Texas, PLLC Otolaryngology CurrentSince Jul 17, 2023 Accepting new patients
Texas Ear, Nose & Throat Specialists, L.L.P. CurrentSince Jul 22, 2015 Accepting new patients
Richard D Thrasher III MD PA Otolaryngology PastSince Jun 25, 2023 Accepting new patients
Bear Creek Surgery Center, LLC PastSince May 16, 2016 Accepting new patients

Locations

1615 Hospital Pkwy
Ste 210
Bedford, TX 76022
Phone (817) 540-3121

5220 W University Dr
Ste 150
McKinney, TX 75071
Phone (972) 632-3270

300 S Nolen Dr
Ste 100
Southlake, TX 76092
Phone (817) 410-7777

Organizations & group practices 4

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 1

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1275769754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 W UNIVERSITY DR STE 150",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717418",
            "telephone_number": "972-984-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S NOLEN DR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928057",
            "telephone_number": "817-989-2400",
            "fax_number": "817-549-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHMEAD",
        "first_name": "MARY",
        "middle_name": "GAJEWSKI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "20090067",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "Q3637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.