Individual provider Active NPI

Alysa Ann Casey

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1700508694
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17347 Issued in TX
Practice address
12720 Hillcrest Rd Ste 625
Dallas, TX 75230-2163
Phone
(469) 830-9600
Fax
(469) 830-9601
NPI assigned
Sep 16, 2022
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 PA17347 TX Primary

Addresses

Primary practice location

12720 Hillcrest Rd Ste 625
Dallas, TX 75230-2163

Mailing address

9330 LBJ Fwy Ste 800
Dallas, TX 75243-4310
Phone (972) 792-9700

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
I20240210000540 TX Practitioner - Physician Assistant 0840633418 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1700508694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 LBJ FWY STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434310",
            "telephone_number": "972-792-9700",
            "fax_number": "469-830-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 HILLCREST RD STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302163",
            "telephone_number": "469-830-9600",
            "fax_number": "469-830-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "ALYSA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.