Individual provider Active NPI

Micaela Dartson, DPM

  • Podiatrist
  • Dallas, TX
National Provider Identifier
1760565329
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1306 Issued in TX
Practice address
4101 McEwen Rd
Ste 625
Dallas, TX 75244-5112
Phone
(214) 221-9116
Fax
(214) 219-1120
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1306 TX Primary

Addresses

Primary practice location

4101 McEwen Rd
Ste 625
Dallas, TX 75244-5112

Mailing address

2500 Maywood LN
McKinney, TX 75070-4393
Phone (214) 725-9663

Other identifiers 3

IdentifierTypeStateIssuer
130986606MedicaidTX
0011AWOtherTXBLUE SHIELD
P00606710OtherTXRAILROAD MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080424000154 TX Practitioner - Podiatry 1850202698 Practice locations: Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Maywood LN
McKinney, TX 75070-4393

4101 McEwen Rd
Suite 625
Dallas, TX 75244-5112
Phone (214) 221-9116

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue705
Removal or shaving of skin growth44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1306TXMDOther Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1760565329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MAYWOOD LN",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750704393",
            "telephone_number": "214-725-9663",
            "fax_number": "972-548-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MCEWEN RD",
            "address_2": "STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445112",
            "telephone_number": "214-221-9116",
            "fax_number": "214-219-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARTSON",
        "first_name": "MICAELA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130986606",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0011AW",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00606710",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.