Individual provider Active NPI

Bruce Fred Schubert, PA

  • Medical Physician Assistant
  • Dalhart, TX
National Provider Identifier
1386614964
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00540 Issued in TX
Practice address
201 Texas Blvd
Dalhart, TX 79022
Phone
(806) 249-8324
Fax
(806) 249-8412
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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 PA00540 TX Primary

Addresses

Primary practice location

201 Texas Blvd
Dalhart, TX 79022

Mailing address

PO Box 1208
Dalhart, TX 79044
Phone (806) 249-8324

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
I20131121000664 TX Practitioner - Physician Assistant 6204965403 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Community Rural Health Clinic Medical Current Accepting new patients
High Country Community Rural Health Clinic, LLC Current Accepting new patients
Dallam-Hartley Counties Hospital District CurrentSince Jan 1, 2013 Accepting new patients
Dallam-Hartley Counties Hospital District CurrentSince Jan 1, 2013 Accepting new patients

Locations

1411 Denver Ave
Dalhart, TX 79022
Phone (806) 244-4571

201 E Texas Blvd
Dalhart, TX 79022
Phone (806) 244-9302

Organizations & group practices 5

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1386614964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1208",
            "city": "DALHART",
            "state": "TX",
            "postal_code": "79044",
            "telephone_number": "806-249-8324",
            "fax_number": "806-249-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TEXAS BLVD",
            "city": "DALHART",
            "state": "TX",
            "postal_code": "79022",
            "telephone_number": "806-249-8324",
            "fax_number": "806-249-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBERT",
        "first_name": "BRUCE",
        "middle_name": "FRED",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalhart, TX

Sources for this page

Verify at the official NPI Registry.