Individual provider Active NPI

Nicole Suerin Kang, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1316819089
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19756 Issued in TX
Practice address
12228 N Central Expy Ste 410
Dallas, TX 75243-3797
Phone
(972) 566-5255
Fax
(972) 566-5236
NPI assigned
Sep 22, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA19756 TX Primary

Addresses

Primary practice location

12228 N Central Expy Ste 410
Dallas, TX 75243-3797

Mailing address

12228 N Central Expy Ste 410
Dallas, TX 75243-3797
Phone (972) 566-5255

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
I20260129003109 TX Practitioner - Physician Assistant 9436637675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Joint Institute, PLLCGroup PAC ID 8325206584, 40 clinicians

Practice addresses (Care Compare)

12228 N Central Expy
Suite 410
Dallas, TX 75243-3797
Phone (972) 566-5255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19756TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Joint Institute, PLLC CurrentSince Jan 14, 2026 Accepting new patients

Locations

12228 N Central Expy
Ste 410
Dallas, TX 75243
Phone (214) 265-5050

3500 Gaston Ave
Dallas, TX 75246

7777 Forest Ln
Ste C135
Dallas, TX 75230
Phone (972) 566-5051

7211 Preston Rd
Ste 2100
Plano, TX 75024
Phone (469) 303-0104

Organizations & group practices 1

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.

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": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1316819089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12228 N CENTRAL EXPY STE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433797",
            "telephone_number": "972-566-5255",
            "fax_number": "972-566-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12228 N CENTRAL EXPY STE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433797",
            "telephone_number": "972-566-5255",
            "fax_number": "972-566-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "NICOLE",
        "middle_name": "SUERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.