NPIMap

Individual provider Active NPI

Dillon McDonald

  • Medical Physician Assistant
  • South Padre Island, TX
National Provider Identifier
1346912680
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5800 Padre Blvd Ste 113
South Padre Island, TX 78597-7615
Phone
(956) 630-7577
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

5800 Padre Blvd Ste 113
South Padre Island, TX 78597-7615

Mailing address

1705 E 30TH St
Mission, TX 78574-1997
Phone (469) 226-8811

Other practice location 1

1109 W Nolana Ave Ste 101
McAllen, TX 78504-3794
Phone (956) 887-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220404001235 TX Practitioner - Physician Assistant 8022404805 Reassigns benefits to 7 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Envoy Health PastSince May 1, 2024 Accepting new patients

Organizations & group practices 8

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": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1346912680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E 30TH ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785741997",
            "telephone_number": "469-226-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 PADRE BLVD STE 113",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "785977615",
            "telephone_number": "956-630-7577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1109 W Nolana Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785043794",
            "country_code": "US",
            "telephone_number": "956-887-8346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DILLON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Padre Island, TX

Sources for this page

Verify at the official NPI Registry.