Individual provider Active NPI

Paul Michael Broker, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1679968309
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S1773 Issued in TX
Practice address
5939 Harry Hines Blvd 8TH FL Ste HQ08.124
Dallas, TX 75390-2612
Phone
(214) 645-8600
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S1773 TX Primary

Addresses

Primary practice location

5939 Harry Hines Blvd 8TH FL Ste HQ08.124
Dallas, TX 75390-2612

Mailing address

PO Box 845347
Dallas, TX 75284-7208

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200109002341 TX Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0648544908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5939 Harry Hines Blvd
Dallas, TX 75235-6246
Phone (214) 645-5505

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5939 Harry Hines Blvd
Fl 8
Dallas, TX 75235
Phone (214) 645-1460

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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 and National Provider Directory roles.

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1679968309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD 8TH FL STE HQ08.124",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753902612",
            "telephone_number": "214-645-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKER",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.