Smitha Susan Thankachan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA03912 Issued in TX

Practice address

975 Sam Rayburn Tollway Ste 140
Allen, TX 75013-6021

Phone

(469) 495-9108

Fax

(469) 495-0708

NPI assigned

Feb 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Urgent CareGroup PAC ID 0345654414, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sthankachan1681272@direct.texashealth.org

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.

• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Arlington, TX
  • NPI 1952915365
  Medicare reassignment Care Compare group NPD
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1104431527
  NPD
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • Allen, TX
  • NPI 1629724315
  NPD
• Texas Health Urgent Care

  dba Texas Health Breeze Urgent Care

  • Urgent Care Clinic/Center
  • McKinney, TX
  • NPI 1972118388
  NPD
• Medspring of Texas, PA

  • Urgent Care Clinic/Center
  • McKinney, TX
  • NPI 1356871347
  NPD (past)

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

{
    "created_epoch": "1266624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676160000000",
    "number": "1750603569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BIRDIE DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135110",
            "telephone_number": "694-434-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SAM RAYBURN TOLLWAY STE 140",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136021",
            "telephone_number": "469-495-9108",
            "fax_number": "469-495-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANKACHAN",
        "first_name": "SMITHA",
        "middle_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-20",
        "last_updated": "2023-02-12",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthankachan1681272@Direct.TexasHealth.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "975 Sam Rayburn Tollway Ste 140",
            "city": "Allen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750136021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Alexandra Marie Thakkar, LCSW
• Annie Thampan
• Rony Thannimoottilchirayil Chacko, AGACNP-BC
• The Art of Orthodontics
• The Bloom Center for Motherhood
• The Blueprint Physical Therapy
• The Children's Dentist of Allen

• Medical Physician Assistant in Allen, TX
• Providers in Allen, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.