Individual provider Active NPI

Shannon Kelsey Della Monica, M.D.

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1588919963
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q9364 Issued in TX
Practice address
6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200
Phone
(214) 802-8203
Fax
(817) 507-1768
NPI assigned
Jul 20, 2012
Last updated
Nov 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301101084 MI
Emergency Medicine Physician 207P00000X Q9364 TX Primary

Addresses

Primary practice location

6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200

Mailing address

6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200
Phone (214) 802-8203

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310000538 TX Practitioner - Emergency Medicine 8426365933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

6200 W Parker Rd
Plano, TX 75093-8185
Phone (972) 981-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

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

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

6451 Brentwood Stair Rd
Ste 200
Ft Worth, TX 76112
Phone (817) 496-9700

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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 2

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1588919963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "214-802-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "214-802-8203",
            "fax_number": "817-507-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLA MONICA",
        "first_name": "SHANNON",
        "middle_name": "KELSEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301101084",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q9364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.