Individual provider Active NPI

Dolly Susan Varghese

  • Nurse Practitioner
  • Plano, TX
National Provider Identifier
1730746199
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP138714 Issued in TX
Practice address
7709 San Jacinto PL Ste 100
Plano, TX 75024-3369
Phone
(469) 406-4245
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP138714 TX Primary

Addresses

Primary practice location

7709 San Jacinto PL Ste 100
Plano, TX 75024-3369

Mailing address

7709 San Jacinto PL Ste 100
Plano, TX 75024-3369
Phone (469) 406-4245

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
I20190802001214 TX Practitioner - Nurse Practitioner 3779810460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advance Wound Care and Hyperbaric Specialists of TexasGroup PAC ID 4981865888, 6 clinicians

Practice addresses (Care Compare)

7709 San Jacinto PL
Suite 100
Plano, TX 75024-3369
Phone (469) 406-4225

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
100
Improvement activities
40
Cost
38.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138714TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Straightline Medical Consultants CurrentSince May 1, 2019 Accepting new patients
Advance Wound Care & Hyperbaric Specialists of Texas CurrentSince May 1, 2023 Accepting new patients

Locations

9900 N Central Expy
Ste 215
Dallas, TX 75231
Phone (214) 355-2600

7709 San Jacinto Pl
Ste 100
Plano, TX 75024
Phone (469) 406-4225

5960 W Parker Rd
Ste 278323
Plano, TX 75093

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1730746199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 SAN JACINTO PL STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243369",
            "telephone_number": "469-406-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 SAN JACINTO PL STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243369",
            "telephone_number": "469-406-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "DOLLY",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP138714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.