Individual provider Active NPI

McKenna Marie Breiner, PA

  • Medical Physician Assistant
  • Dallas, TX
National Provider Identifier
1679043897
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390
Phone
(214) 648-2509
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (832) 928-2176

Other practice location 1

62 Pagehurst Ct
The Woodlands, TX 77382-2548
Phone (832) 928-2176

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
I20190528000401 TX Practitioner - Physician Assistant 9739422148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

13621 Skinner Rd
Suite 100
Cypress, TX 77429-7283
Phone (281) 754-3034

14099 FM 2920 Rd
Suite a
Tomball, TX 77377-5546
Phone (281) 803-9828

8850 Spencer Hwy
La Porte, TX 77571-3736
Phone (281) 946-9980

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2019 Accepting new patients
Southlake Doctors Express, PA PSC Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2019 Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients

Locations

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

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 6

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": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1679043897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "832-928-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-648-2509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Pagehurst Ct",
            "address_purpose": "LOCATION",
            "city": "The Woodlands",
            "state": "TX",
            "postal_code": "773822548",
            "country_code": "US",
            "telephone_number": "832-928-2176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREINER",
        "first_name": "MCKENNA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.