Individual provider Active NPI

Josana Elizabeth Collins, PA-C

  • Physician Assistant
  • Colleyville, TX
National Provider Identifier
1821617556
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13369 Issued in TX
Practice address
5849 Crescent LN
Colleyville, TX 76034-7630
Phone
(909) 226-1722
NPI assigned
Apr 13, 2020
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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 PA13369 TX Primary

Addresses

Primary practice location

5849 Crescent LN
Colleyville, TX 76034-7630

Mailing address

5849 Crescent LN
Colleyville, TX 76034-7630
Phone (909) 226-1722

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
I20210810004062 TX Practitioner - Physician Assistant 7113321324 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mansfield Dermatology, PLLCGroup PAC ID 2769545458, 10 clinicians
United Dermatology Associates of Euless, PLLCGroup PAC ID 2961841572, 3 clinicians
United Dermatology Associates of Arlington, PLLCGroup PAC ID 3476954561, 7 clinicians
United Dermatology Associates of Burleson, PLLCGroup PAC ID 8628294220, 6 clinicians

Practice addresses (Care Compare)

130 Regency Pkwy
Mansfield, TX 76063-5167
Phone (817) 539-0959

2101 Westpark CT
Suite 150
Euless, TX 76040-3717
Phone (817) 261-1122

2800 E Broad St
124 United Dermatology Associates
Mansfield, TX 76063-6410
Phone (817) 539-0959

3132 Matlock Rd
Suite 307
Arlington, TX 76015-2922
Phone (817) 539-0959

780 NE Alsbury Blvd
Suite B
Burleson, TX 76028-2641
Phone (817) 539-0959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA13369TXMDPhysician Assistant

Organizations & group practices 5

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1821617556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 CRESCENT LN",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760347630",
            "telephone_number": "909-226-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 CRESCENT LN",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760347630",
            "telephone_number": "909-226-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JOSANA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

Verify at the official NPI Registry.