Shang Jun Meng, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07312 Issued in TX

Practice address

12221 Merit Dr Ste 1610
Dallas, TX 75251-2204

Phone

(214) 217-1911

Fax

(214) 217-1912

NPI assigned

Apr 20, 2011

Last updated

May 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Emergency Services of Texas PA

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1174932131
  Medicare reassignment
• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011
  Medicare reassignment
• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1649669672
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1720379126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512204",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512204",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENG",
        "first_name": "SHANG",
        "middle_name": "JUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282395702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34352074",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282395701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282395703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latonya Rena Menefee, PHARM.D
• Erick Menegazzo, DDS
• Luigi Fernando Meneghini, M.D.
• Emily Meng
• Jin Meng, MD
• Xiaosong Meng, M.D., PH.D.
• Gabriella Mengistu, PT, DPT
• Sarah Elizabeth Menhart, CPHT
• Alex Menjivar
• Robert Gary Mennel, MD

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.