Individual provider Active NPI

Laura L McDonough, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1922098268
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01102 Issued in TX
Practice address
3900 Junius St
Suite 500
Dallas, TX 75246-1615
Phone
(214) 823-7090
Fax
(214) 823-1644
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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 PA01102 TX Primary

Addresses

Primary practice location

3900 Junius St
Suite 500
Dallas, TX 75246-1615

Mailing address

3900 Junius St
Suite 500
Dallas, TX 75246-1615
Phone (214) 823-7090

Other identifiers 2

IdentifierTypeStateIssuer
298658001MedicaidTX
8N3085OtherTXBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmcdonough220768@direct.sw.org

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
I20100831000715 TX Practitioner - Physician Assistant 8224152012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3900 Junius St
Suite 500
Dallas, TX 75246-1621
Phone (214) 823-7090

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01102TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Mar 1, 2012 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3900 Junius St
Ste 500
Dallas, TX 75246
Phone (214) 823-7090

Interoperability endpoints

  • Direct secure messaging: lmcdonough220768@direct.sw.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 and National Provider Directory roles.

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1922098268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461615",
            "telephone_number": "214-823-7090",
            "fax_number": "214-823-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461615",
            "telephone_number": "214-823-7090",
            "fax_number": "214-823-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298658001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N3085",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmcdonough220768@direct.sw.org",
            "affiliation": "N",
            "address_1": "3900 Junius St",
            "address_2": "Suite 500",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.