Individual provider Active NPI

Gregg Fletcher

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1679801054
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06405 Issued in TX
Practice address
221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312
Phone
(214) 960-5681
Fax
(214) 960-5681
NPI assigned
Nov 24, 2009
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 PA06405 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312

Mailing address

5605 N Macarthur Blvd Ste 740
Irving, TX 75038-2626
Phone (214) 960-5681

Other practice location 1

8995 Stacy Rd
McKinney, TX 75070-2167
Phone (612) 225-1538

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
I20100209000414 TX Practitioner - Physician Assistant 0143363424 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians
Questcare Intensivists PLLCGroup PAC ID 4688715691, 67 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

5252 W University Dr
McKinney, TX 75071-7822
Phone (954) 939-5000

713 E Anderson St
Weatherford, TX 76086-5705
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2310OKMDOptometrist
PA06405TXMDPhysician Assistant

Organizations & group practices 7

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 1

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1679801054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 N MACARTHUR BLVD STE 740",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382626",
            "telephone_number": "214-960-5681",
            "fax_number": "214-960-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD STE 525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082312",
            "telephone_number": "214-960-5681",
            "fax_number": "214-960-5681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8995 Stacy Rd",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "750702167",
            "country_code": "US",
            "telephone_number": "612-225-1538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "GREGG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.