Individual provider Active NPI

Kun Hee Roh

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1770264038
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1130188 Issued in TX
Practice address
5161 Harry Hines Blvd
Dallas, TX 75390-8860
Phone
(214) 645-2080
NPI assigned
Jul 28, 2023
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1130188 TX Primary
Acute Care Nurse Practitioner 363LA2100X 1130188 TX

Addresses

Primary practice location

5161 Harry Hines Blvd
Dallas, TX 75390-8860

Mailing address

5161 Harry Hines Blvd
Dallas, TX 75390-8860

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
I20231122000961 TX Practitioner - Nurse Practitioner 9830547363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5161 Harry Hines Blvd
Dallas, TX 75235-7707
Phone (214) 645-0624

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

2655 Villa Creek Dr
Farmers Branch, TX 75234
Phone (214) 736-8376

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: kroh301900@direct.phhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1770264038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5161 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908860",
            "telephone_number": "214-645-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROH",
        "first_name": "KUN",
        "middle_name": "HEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1130188",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1130188",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.