Individual provider Active NPI

Miakka Nicole Jalloh, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1376939991
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R0791 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8000
Fax
(214) 648-5461
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R0791 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (972) 863-0645

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925002399 TX Practitioner - AnesthesiologyPractitioner - Pain Management 1052730967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Practice addresses (Care Compare)

5500 Frisco Square Blvd
Frisco, TX 75034-3305
Phone (214) 618-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomed Staffing LLC Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients

Locations

801 W Interstate 20
Arlington, TX 76017
Phone (817) 472-3400

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

5500 Frisco Square Blvd
Frisco, TX 75034
Phone (214) 618-0500

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

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

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Organizations & group practices 2

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1376939991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "972-863-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8000",
            "fax_number": "214-648-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOH",
        "first_name": "MIAKKA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R0791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.