Individual provider Active NPI

Jillian Robinson, PA-C

  • Surgical Physician Assistant
  • Dallas, TX
National Provider Identifier
1477916922
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1411 N Beckley Ave
Suite 363
Dallas, TX 75203-1259
Phone
(214) 946-3687
NPI assigned
Apr 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1411 N Beckley Ave
Suite 363
Dallas, TX 75203-1259

Mailing address

1411 N Beckley Ave
Pav 3 Suite 363
Dallas, TX 75203-1259
Phone (214) 946-3687

Other practice location 1

1900 Matlock Rd Ste 304
Mansfield, TX 76063-4435
Phone (817) 952-8221

Other practice location 2

4709 W Parker Rd Ste 430
Plano, TX 75093-3369
Phone (972) 767-9229

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
I20160721000537 TX Practitioner - Physician Assistant 3870886385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Divali Docs, PLLCGroup PAC ID 0840571857, 4 clinicians

Practice addresses (Care Compare)

1411 N Beckley Ave
Dallas, TX 75203-1262
Phone (469) 620-0222

4709 W Parker Rd
430 DFW Bariatrics and General Surgery
Plano, TX 75093-3369
Phone (469) 620-0222

Hospital & facility affiliations

  • Usmd Hospital at Arlington L P Hospital, Arlington, TX, CCN 450872

National Provider Directory

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

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.

Hospital & facility affiliations 1

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1477916922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAV 3 SUITE 363",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-946-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "SUITE 363",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-946-3687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Matlock Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760634435",
            "country_code": "US",
            "telephone_number": "817-952-8221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4709 W Parker Rd Ste 430",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750933369",
            "country_code": "US",
            "telephone_number": "972-767-9229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.