Shana Fakkel, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

11910 Greenville Ave
Suite 500
Dallas, TX 75243-3596

Phone

(214) 572-1124

Fax

(214) 572-7724

NPI assigned

Mar 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primamed Physicians, PLLCGroup PAC ID 9234027897, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shana.fakkelpac.p11@direct.nextcare.nextgenshare.com

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.

• Primamed Physicians PLLC

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1164494068
  Medicare reassignment Care Compare group NPD
• Citimed, P.a.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1487823316
  NPD (past)
• Primacare Medical Centers

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1104905728
  NPD (past)

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1659612752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKKEL",
        "first_name": "SHANA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Residential House Inc #1
• Emily Paige Faith, MA, LPC-ASSOCIATE
• Ramon Miguel Fajardo
• Juveria Fakhruddin
• John William Fakhry
• Nina Somalie Fakunle, FNP-C
• Falafulking Dental PLLC
• Damilola Faith Falana
• Folasade Falana, CCC-SLP
• Andrew Falcinelli, PT, DPT

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.