Individual provider Active NPI

Diana Rodriguez-Carrillo

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1669207858
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18893 Issued in TX
Practice address
1111 W Ledbetter Dr Ste 800
Dallas, TX 75224-4966
Phone
(214) 330-9221
Fax
(214) 999-9363
NPI assigned
Sep 5, 2024
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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 PA18893 TX Primary

Addresses

Primary practice location

1111 W Ledbetter Dr Ste 800
Dallas, TX 75224-4966

Mailing address

700 N Pearl St Ste N510
Dallas, TX 75201-2863
Phone (214) 580-7277

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
I20260228000031 TX Practitioner - Physician Assistant 3577045475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metroplex Care GroupGroup PAC ID 8022239565, 20 clinicians

Practice addresses (Care Compare)

2701 S Hampton Rd
Suite 101
Dallas, TX 75224-2363
Phone (214) 330-9221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA18893TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metroplex Care Group CurrentSince Jan 20, 2026 Accepting new patients
Metroplex Care Group CurrentSince Jan 20, 2026 Accepting new patients

Locations

2701 S Hampton Rd
Ste 101
Dallas, TX 75224
Phone (214) 330-9221

700 N Pearl St
Ste N510
Dallas, TX 75201

Interoperability endpoints

  • Direct secure messaging: dianarodriguez-carrillo@gfmc.allscriptsdirect.net

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, 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": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1669207858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N PEARL ST STE N510",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012863",
            "telephone_number": "214-580-7277",
            "fax_number": "214-999-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W LEDBETTER DR STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752244966",
            "telephone_number": "214-330-9221",
            "fax_number": "214-999-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-CARRILLO",
        "first_name": "DIANA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.