Individual provider Active NPI

Melanie Kay Chung Sherman, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1710124383
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
40481 Issued in TX
Practice address
6363 Forest Park Rd 7TH FL Ste 749
Dallas, TX 75390-2033
Phone
(214) 645-8500
Fax
(214) 648-3775
NPI assigned
Jan 19, 2009
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 40481 TX Primary

Addresses

Primary practice location

6363 Forest Park Rd 7TH FL Ste 749
Dallas, TX 75390-2033

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL xxxx Health Information Exchange (HIE)

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090305000401 TX Practitioner - Clinical Social Worker 1557427119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6363 Forest Park Rd 7TH FL
749 Univ of TX SW Med Ctr Psych
Dallas, TX 75390-9087
Phone (214) 645-8500

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40481TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 13, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 13, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Assurasource LTD Clinical PastSince Apr 10, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Jun 5, 2022 Accepting new patients

Locations

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

6363 Frst Park Rd 7th Fl
Ste 749
Dallas, TX 75390
Phone (214) 645-8500

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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, 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": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1710124383",
    "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": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FOREST PARK RD 7TH FL STE 749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753902033",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MELANIE",
        "middle_name": "KAY CHUNG",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "xxxx",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6363 Forest Park Rd 7th Fl Ste 749",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "753902033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.