Individual provider Active NPI

Susana Munoz Ortiz

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1316609910
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1054561 Issued in TX
Practice address
410 E Pioneer Pkwy Ste 300
Grand Prairie, TX 75051-4984
Phone
(469) 733-1890
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1054561 TX Primary

Addresses

Primary practice location

410 E Pioneer Pkwy Ste 300
Grand Prairie, TX 75051-4984

Mailing address

122 W John Carpenter Fwy Ste 420
Irving, TX 75039-2014
Phone (972) 957-3000

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
I20211028002568 TX Practitioner - Nurse Practitioner 4486042132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Topcare Medical Group IncGroup PAC ID 8426239153, 71 clinicians

Practice addresses (Care Compare)

229 NE 28TH St
Clinicas Mi Doctor
Fort Worth, TX 76164-7205
Phone (817) 566-0483

410 E Pioneer Pkwy
300 Clinicas Mi Doctor
Grand Prairie, TX 75051-4984
Phone (469) 733-1890

9753 Webb Chapel Rd
900 Clinicas Mi Doctor
Dallas, TX 75220-3513
Phone (214) 622-6050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1054561TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Topcare Medical PA CurrentSince Apr 2, 2012 Accepting new patients
Topcare Medical Group Inc CurrentSince Dec 1, 2022 Accepting new patients

Locations

12377 Merit Dr
Ste 300
Dallas, TX 75251

229 NE 28th St
Ft Worth, TX 76164
Phone (817) 566-0478

410 E Pioneer Pkwy
Ste 300
Grand Prairie, TX 75051
Phone (469) 733-1890

122 W John Carpenter Fwy
Ste 420
Irving, TX 75039

222 Las Colinas Blvd W
Ste 2000
Irving, TX 75039

1120 E Parker Rd
Ste 195
Plano, TX 75074
Phone (469) 298-1216

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1316609910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W JOHN CARPENTER FWY STE 420",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392014",
            "telephone_number": "972-957-3000",
            "fax_number": "972-957-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E PIONEER PKWY STE 300",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514984",
            "telephone_number": "469-733-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ ORTIZ",
        "first_name": "SUSANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1054561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.