Active NPI
Patricia Ann Decker, PA
- Physician Assistant
- Grapevine, TX
National Provider Identifier
1972504322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00996
- Practice address
- 1631 Lancaster Dr
Suite 150
Grapevine, TX 76051-3585 - Phone
- (817) 251-9080
- Fax
- (817) 251-9082
- NPI assigned
- Aug 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00996 | TX | Primary |
Addresses
Primary practice location
1631 Lancaster Dr
Suite 150
Grapevine, TX 76051-3585
Mailing address
PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217557201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Clinic of North Texas PLLC | Past | Accepting new patients | |
| Urology Associates of North Texas LLP | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
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-
- Urology Physician
- Weatherford, TX
- NPI 1407849961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299542400000",
"number": "1972504322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911230",
"city": "DALLAS",
"state": "TX",
"postal_code": "753911230",
"telephone_number": "972-997-8000",
"fax_number": "972-234-2987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 LANCASTER DR",
"address_2": "SUITE 150",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760513585",
"telephone_number": "817-251-9080",
"fax_number": "817-251-9082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "PATRICIA",
"middle_name": "ANN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2011-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA00996",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "217557201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grapevine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.