Individual provider Active NPI

Shawn Matthew Sommerlad, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1689978769
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07102 Issued in TX
Practice address
8230 Walnut Hill LN Ste 220
Dallas, TX 75231-4425
Phone
(214) 345-8692
NPI assigned
Jan 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 PA07102 TX Primary

Addresses

Primary practice location

8230 Walnut Hill LN Ste 220
Dallas, TX 75231-4425

Mailing address

8230 Walnut Hill LN Ste 220
Dallas, TX 75231-4425
Phone (214) 345-8692

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
I20110412000378 TX Practitioner - Physician Assistant 3375727696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CardiocentricGroup PAC ID 5092146332, 3 clinicians

Practice addresses (Care Compare)

1401 Seminole Dr
Richardson, TX 75080-3738
Phone (972) 757-7928

Hospital & facility affiliations

  • Coralvita Richardson Hospital, Richardson, TX, CCN 670348
  • Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537
  • Medical City Plano Hospital, Plano, TX, CCN 450651

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07102TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 2, 2011 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 2, 2011 Accepting new patients
Shawn Sommerlad PLLC CurrentSince May 10, 2020 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

8230 Walnut Hill Ln
Ste 220
Dallas, TX 75231
Phone (214) 345-8692

8440 Walnut Hill Ln
Ste 610
Dallas, TX 75231
Phone (214) 345-6000

8230 Walnut Hill Ln
Ste 204
Dallas, TX 75231
Phone (214) 345-6000

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Organizations & group practices 5

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 3

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": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1689978769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN STE 220",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314425",
            "telephone_number": "214-345-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN STE 220",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314425",
            "telephone_number": "214-345-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERLAD",
        "first_name": "SHAWN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-04",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.