NPIMap

Individual provider Active NPI

Stephen J Kimatian, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1407807555
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R3700 Issued in TX
Practice address
1935 Medical District Dr # D2.08
Dallas, TX 75235-7701
Phone
(214) 456-6393
Fax
(214) 456-7232
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X R3700 TX
Anesthesiology Physician 207L00000X R3700 TX Primary

Addresses

Primary practice location

1935 Medical District Dr # D2.08
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
D2.08
Dallas, TX 75235
Phone (214) 456-6393

Other identifiers 1

IdentifierTypeStateIssuer
0018041700001MedicaidPA

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
I20170721002530 TX Practitioner - Anesthesiology 9638226863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Buffalo School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-0624

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc Anesthesiology CurrentSince Jan 1, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients
Dallas Physician Medical Services for Children Inc CurrentSince Jan 1, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2017 Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

1935 Medical District Dr
Unit A
Dallas, TX 75235

1935 Medical District Dr
#D208
Dallas, TX 75235

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

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

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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.

Hospital & facility affiliations 46

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407807555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "D2.08",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75235",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR # D2.08",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMATIAN",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "R3700",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R3700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018041700001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.