Individual provider Active NPI

Mary Ellen Solis Nguyen, PT, MS

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1568756583
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1153291 Issued in TX
Practice address
16250 Knoll Trail Dr Ste 101
Dallas, TX 75248-2868
Phone
(214) 679-3891
Fax
(469) 405-2994
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1153291 TX Primary

Addresses

Primary practice location

16250 Knoll Trail Dr Ste 101
Dallas, TX 75248-2868

Mailing address

PO Box 835613
Richardson, TX 75083-5613
Phone (214) 679-3891

Other identifiers 3

IdentifierTypeStateIssuer
1346875275OtherTXORGANIZATIONAL NPI
1568756583OtherTXNPI
1153291OtherTXTEXAS PHYSICAL THERAPY BOARD OF EXAMINERS

Other names 1

  • Miss Mary Ellen Solis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140221000179 TX Practitioner - Physical Therapist in Private Practice 6608006572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Ellen NguyenGroup PAC ID 5597195404, 4 clinicians

Practice addresses (Care Compare)

16250 Knoll Trail Dr
Dallas, TX 75248-2874
Phone (214) 679-3891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1153291TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Ellen Nguyen Physical Therapist CurrentSince Mar 11, 2020 Accepting new patients

Locations

16250 Knoll Trail Dr
Ste 101
Dallas, TX 75248
Phone (214) 679-3891

6911 Frankford Rd
Dallas, TX 75252

Organizations & group practices 1

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1568756583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835613",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750835613",
            "telephone_number": "214-679-3891",
            "fax_number": "469-405-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 KNOLL TRAIL DR STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482868",
            "telephone_number": "214-679-3891",
            "fax_number": "469-405-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MARY ELLEN",
        "middle_name": "SOLIS",
        "name_prefix": "Mrs.",
        "credential": "PT, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1153291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1346875275",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568756583",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PHYSICAL THERAPY BOARD OF EXAMINERS",
            "identifier": "1153291",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SOLIS",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "credential": "PT, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.