NPIMap

Individual provider Active NPI

Michael Saucedo

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1801669221
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17532 Issued in TX
Practice address
5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200
Phone
(214) 648-1500
NPI assigned
Nov 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 PA17532 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200

Mailing address

5225 Maple Ave Apt 4216
Dallas, TX 75235-8448
Phone (512) 638-5417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409003441 TX Practitioner - Physician Assistant 2264870278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1800 N Britain Rd
Parkland Health
Irving, TX 75061-2630
Phone (214) 266-3000

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17532TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Apr 1, 2024 Accepting new patients
Dallas County Hospital District CurrentSince Apr 1, 2024 Accepting new patients

Locations

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1801669221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 MAPLE AVE APT 4216",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358448",
            "telephone_number": "512-638-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907200",
            "telephone_number": "214-648-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEDO",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.