Michael Daniel Shortt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06116 Issued in TX

Practice address

18152 Preston Rd Ste I-2
Dallas, TX 75252-5427

Phone

(469) 200-2832

Fax

(469) 269-1074

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Doctx3 PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1467808618
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Doctx3 PLLC

  • Durable Medical Equipment & Medical Supplies
  • Denton, TX
  • NPI 1235792169
  NPD (past)
• Scott a Welsh MD PA

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1952580425
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1972640266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18152 PRESTON RD STE I-2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525427",
            "telephone_number": "469-200-2832",
            "fax_number": "469-269-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18152 PRESTON RD STE I-2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525427",
            "telephone_number": "469-200-2832",
            "fax_number": "469-269-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTT",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336426701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shooting Stars Early Intervention & Therapy Services LLC
• Puranjay Shori, MPH
• Kaitlin Short, MS, LPC, NCC
• Katrina Margaret Short, PT
• Rebecca Ann Short, M.D.
• Nancy Soll Shosid, M.D.
• Jennifer Cummings Shotwell, LCDC
• Kelsi Alexis Shough, OTR/L
• Sonia Shoukat, M.D
• Thomas Hugh Shoultz, M.D.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.