Individual provider Active NPI

Shiv Bhakta, PA

  • Physician Assistant
  • Coppell, TX
National Provider Identifier
1952912917
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16244 Issued in TX
Practice address
670 N Macarthur Blvd
Coppell, TX 75019-2710
Phone
(972) 745-4446
Fax
(972) 745-2597
NPI assigned
Aug 13, 2020
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 PA16244 TX Primary

Addresses

Primary practice location

670 N Macarthur Blvd
Coppell, TX 75019-2710

Mailing address

670 N Macarthur Blvd
Coppell, TX 75019-2710
Phone (972) 745-4446

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
I20230403000618 TX Practitioner - Physician Assistant 4688049760 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16244TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC Physician Assistant CurrentSince Apr 10, 2023 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Apr 10, 2023 Accepting new patients
Wellmed Medical Group, PA CurrentSince Dec 1, 2024 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Dec 1, 2024 Accepting new patients
Integrative Medical of DFW LLC PastSince Apr 5, 2020 Accepting new patients

Locations

1601 W Hebron Pkwy
Ste 100
Carrollton, TX 75010
Phone (972) 426-8675

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1952912917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192710",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192710",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "SHIV",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

Verify at the official NPI Registry.