Individual provider Active NPI

Jennifer Lisch Miron, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1336486752
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08252 Issued in TX
Practice address
8220 Walnut Hill LN Ste 710
Dallas, TX 75231-4427
Phone
(214) 368-6707
Fax
(214) 368-1804
NPI assigned
Jan 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9112291 FL
Physician Assistant 363A00000X PA08252 TX Primary

Addresses

Primary practice location

8220 Walnut Hill LN Ste 710
Dallas, TX 75231-4427

Mailing address

7610 N Stemmons Fwy Ste 600
Dallas, TX 75247-4228
Phone (214) 689-5960

Other names 1

  • Jennifer Lynn Lisch Former name

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
I20130427000086 TX Practitioner - Physician Assistant 2860638467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

701 Tuscan Dr
Suite 110
Irving, TX 75039-3838
Phone (214) 496-1100

8220 Walnut Hill LN
Suite 710
Dallas, TX 75231-4427
Phone (214) 368-6707

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA08252TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

8220 Walnut Hill Ln
Ste 710
Dallas, TX 75231
Phone (214) 368-6707

701 Tuscan Dr
Ste 110
Irving, TX 75039
Phone (214) 496-1100

7501 Lakeview Pkwy
Ste 260
Rowlett, TX 75088
Phone (972) 475-8183

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1336486752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 N STEMMONS FWY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474228",
            "telephone_number": "214-689-5960",
            "fax_number": "469-713-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN STE 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314427",
            "telephone_number": "214-368-6707",
            "fax_number": "214-368-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRON",
        "first_name": "JENNIFER",
        "middle_name": "LISCH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9112291",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LISCH",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.