Individual provider Active NPI

Joseph Martin Cuellar, PA-C

  • Physician Assistant
  • Hurst, TX
National Provider Identifier
1770019283
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11384 Issued in TX
Practice address
779 Grapevine Hwy
Hurst, TX 76054-2805
Phone
(817) 428-7300
Fax
(817) 428-1085
NPI assigned
May 3, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11384 TX Primary

Addresses

Primary practice location

779 Grapevine Hwy
Hurst, TX 76054-2805

Mailing address

645 E State Highway 121 Ste 600
Coppell, TX 75019-7942
Phone (972) 906-8107

Other practice location 1

2460 N Ih 35 E
Ste. 225
Waxahachie, TX 75165-5266
Phone (214) 826-1730

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
I20210810002248 TX Practitioner - Physician Assistant 7113321373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

1501 Hwy 287 N
Mansfield, TX 76063-4855
Phone (817) 453-8080

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

345 N Hwy 67
Cedar Hill, TX 75104-2134
Phone (972) 956-5300

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

39769 Lyndon B Johnson Fwy
Dallas, TX 75237-3560
Phone (972) 780-0802

454 N Jim Wright Fwy
White Settlement, TX 76108-1437
Phone (682) 703-4505

5653 McPherson Blvd
Fort Worth, TX 76123-6023
Phone (682) 354-3100

7400 McCart Ave
Fort Worth, TX 76133-7270
Phone (817) 294-1651

8450 E Fwy
Fort Worth, TX 76120-4413
Phone (817) 459-2005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA11384TXMDPhysician Assistant

Organizations & group practices 1

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770019283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E STATE HIGHWAY 121 STE 600",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197942",
            "telephone_number": "972-906-8107",
            "fax_number": "972-956-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 GRAPEVINE HWY",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542805",
            "telephone_number": "817-428-7300",
            "fax_number": "817-428-1085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 N Ih 35 E",
            "address_2": "Ste. 225",
            "address_purpose": "LOCATION",
            "city": "Waxahachie",
            "state": "TX",
            "postal_code": "751655266",
            "country_code": "US",
            "telephone_number": "214-826-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "JOSEPH",
        "middle_name": "MARTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.