Individual provider Active NPI

Alisandra Margaret Dirickson

  • Physician Assistant
  • Brownwood, TX
National Provider Identifier
1376061911
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11439 Issued in TX
Practice address
101 A South Park Drive
Brownwood, TX 76801
Phone
(325) 646-6568
Fax
(325) 646-9199
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11439 TX Primary

Addresses

Primary practice location

101 A South Park Drive
Brownwood, TX 76801

Mailing address

PO Box 188
Goldthwaite, TX 76844-0188
Phone (325) 451-0910

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
I20221230000341 TX Practitioner - Physician Assistant 4385014729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2800 E Hwy 114 220
Baylor Scott and White Primary Care Trophy CL
Trophy Club, TX 76262-5307
Phone (817) 912-8900

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 5, 2022 Accepting new patients
Robert L. Hogue M.D. PA PastSince Jun 11, 2011 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

5232 Colleyville Blvd
Ste 100
Colleyville, TX 76034
Phone (817) 909-0925

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

400 W Lyndon B Johnson Fwy
Ste 210
Irving, TX 75063
Phone (972) 869-2772

620 S Main St
Ste 240
Keller, TX 76248
Phone (817) 912-8150

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: adirickson1136399@direct.sw.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1376061911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "GOLDTHWAITE",
            "state": "TX",
            "postal_code": "768440188",
            "telephone_number": "325-451-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 A SOUTH PARK DRIVE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "76801",
            "telephone_number": "325-646-6568",
            "fax_number": "325-646-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRICKSON",
        "first_name": "ALISANDRA",
        "middle_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownwood, TX

Sources for this page

Verify at the official NPI Registry.