Individual provider Active NPI

Alakananda Jwala, PA-C

  • Medical Physician Assistant
  • Frisco, TX
National Provider Identifier
1972744464
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA05671 Issued in TX
Practice address
12505 Lebanon Rd
Frisco, TX 75035-8298
Phone
(972) 963-3039
NPI assigned
Mar 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA05671 TX Primary

Addresses

Primary practice location

12505 Lebanon Rd
Frisco, TX 75035-8298

Mailing address

12505 Lebanon Rd
Frisco, TX 75035-8298
Phone (972) 963-3039

Other identifiers 1

IdentifierTypeStateIssuer
220060201MedicaidTX

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
I20090804000753 TX Practitioner - Physician Assistant 0042363350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Emergency Physicians of Frisco, PAGroup PAC ID 1456590371, 9 clinicians

Practice addresses (Care Compare)

3800 Gaylord Pkwy
Suite 140
Frisco, TX 75034-9418
Phone (469) 800-2100

5601 Warren Pkwy
Frisco, TX 75034-4069
Phone (214) 407-5000

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1972744464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12505 LEBANON RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358298",
            "telephone_number": "972-963-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 LEBANON RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358298",
            "telephone_number": "972-963-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JWALA",
        "first_name": "ALAKANANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220060201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.