NPIMap

Individual provider Active NPI

Kathryn A Minor, PAC

  • Surgical Physician Assistant
  • Dallas, TX
National Provider Identifier
1356427934
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA06362 Issued in TX
Practice address
7777 Forest LN Ste D400
Suite 301
Dallas, TX 75230-6899
Phone
(972) 566-7790
Fax
(972) 566-5819
NPI assigned
Oct 27, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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 PA12217 CA
Surgical Physician Assistant 363AS0400X PA06362 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste D400
Suite 301
Dallas, TX 75230-6899

Mailing address

PO Box 911230
Suite 301
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 4

IdentifierTypeStateIssuer
P01932457OtherTXRAILROAD
345574302MedicaidTX
345574303MedicaidTX
PA12217MedicaidCA

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
I20130925000098 TX Practitioner - Physician Assistant 1850535295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 911242
Dallas, TX 75391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA12217CAMDSurgical Physician Assistant
PA06362TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Aug 29, 2016 Accepting new patients
Digestive Health Associates of Texas, P.a. Past Accepting new patients
California Cancer Specialists Medical Group Inc Past Accepting new patients

Locations

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7777 Forest Ln
Ste D400
Dallas, TX 75230
Phone (972) 566-6647

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

4708 Alliance Blvd
Ste 150
Plano, TX 75093
Phone (972) 596-7801

3144 Horizon Rd
Ste 110
Rockwall, TX 75032
Phone (469) 314-5155

Interoperability endpoints

  • Direct secure messaging: kathryn.minor@txo.ikm.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1356427934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "address_2": "SUITE 301",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE D400",
            "address_2": "SUITE 301",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306899",
            "telephone_number": "972-566-7790",
            "fax_number": "972-566-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA12217",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01932457",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345574302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345574303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA12217",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.