Individual provider Active NPI

Jie Ding, PA-C

  • Surgical Physician Assistant
  • Dallas, TX
National Provider Identifier
1780990218
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4677 Issued in AZ
Practice address
11910 Greenville Ave Ste 500
Dallas, TX 75243-9331
Phone
(214) 343-0058
NPI assigned
Aug 22, 2010
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4677 AZ Primary

Addresses

Primary practice location

11910 Greenville Ave Ste 500
Dallas, TX 75243-9331

Mailing address

11910 Greenville Ave Ste 500
Dallas, TX 75243-9331
Phone (214) 343-0058

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
I20150105000834 TX Practitioner - Physician Assistant 1355535980 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4677AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph G. Abdo, M.D., P.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1282435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1780990218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752439331",
            "telephone_number": "214-343-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752439331",
            "telephone_number": "214-343-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DING",
        "first_name": "JIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-22",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.