Individual provider Active NPI

Casey Dustin Elliott, PA-C

  • Physician Assistant
  • Keller, TX
National Provider Identifier
1598951733
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04628 Issued in TX
Practice address
100 Bourland Rd Ste 170
Keller, TX 76248-3592
Phone
(817) 741-2001
Fax
(817) 741-2015
NPI assigned
Sep 21, 2007
Last updated
Jul 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04628 TX Primary

Addresses

Primary practice location

100 Bourland Rd Ste 170
Keller, TX 76248-3592

Mailing address

100 Bourland Rd Ste 170
Keller, TX 76248-3592
Phone (817) 741-2001

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
I20080229000597 TX Practitioner - Physician Assistant 6406930338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

100 Bourland Rd
Suite 170
Keller, TX 76248-3592
Phone (817) 741-2001

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

251 Westpark Way
Suite 212
Euless, TX 76040-3707
Phone (214) 570-2319

8440 Walnut Hill LN
Suite 800
Dallas, TX 75231-3825
Phone (214) 345-5999

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 1, 2013 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2013 Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

100 Bourland Rd
Ste 170
Keller, TX 76248
Phone (817) 741-2001

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: celliott1356274@direct.texashealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1598951733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BOURLAND RD STE 170",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483592",
            "telephone_number": "817-741-2001",
            "fax_number": "817-741-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOURLAND RD STE 170",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483592",
            "telephone_number": "817-741-2001",
            "fax_number": "817-741-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CASEY",
        "middle_name": "DUSTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.