NPIMap

Individual provider Active NPI

Daniel Barkman Wimmer III, DO

  • Dermatopathology (Pathology) Physician
  • Irving, TX
National Provider Identifier
1407173099
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
Q1774 Issued in TX
Practice address
6655 N Macarthur Blvd
Irving, TX 75039-2443
Phone
(214) 277-8700
Fax
(214) 596-7484
NPI assigned
Apr 22, 2010
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Dermatopathology (Pathology) Physician 207ZD0900X Q1774 TX Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Q1774 TX

Addresses

Primary practice location

6655 N Macarthur Blvd
Irving, TX 75039-2443

Mailing address

PO Box 840294
Dallas, TX 75284-0294
Phone (888) 344-1160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160728002635 TX Practitioner - Pathology 1153614078 Reassigns benefits to 2 organizations
I20220126001178 LA Practitioner - Pathology 1153614078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

5339 Odonovan Dr
Baton Rouge, LA 70808-4388
Phone (225) 766-4999

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 291-6161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q1774TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Group of Louisiana, a Professional Medical Corporation Dermatopathology CurrentSince Jan 1, 2022 Accepting new patients
Pathology Group of Louisiana, a Professional Medical Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2022 Accepting new patients
Inform Diagnostics, Inc. Anatomic Pathology & Clinical Pathology Current Accepting new patients
Associated Clinicians of East Texas Anatomic Pathology & Clinical Pathology CurrentSince Jan 18, 2022 Accepting new patients
Metroplex Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Jul 5, 2016 Accepting new patients
Woman's Specialty Clinic Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

5339 Odonovan Dr
Baton Rouge, LA 70808
Phone (225) 766-4999

1111 S Freeport Pkwy
Coppell, TX 75019
Phone (214) 277-8700

6655 N MacArthur Blvd
Irving, TX 75039
Phone (214) 277-8700

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

Organizations & group practices 7

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 10

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": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1407173099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840294",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840294",
            "telephone_number": "888-344-1160",
            "fax_number": "972-331-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392443",
            "telephone_number": "214-277-8700",
            "fax_number": "214-596-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMMER",
        "first_name": "DANIEL",
        "middle_name": "BARKMAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-22",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "TX",
            "license": "Q1774",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "Q1774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.