Individual provider Active NPI

Kristen Diane Bachus, PA-C

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1982030722
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08579 Issued in TX
Practice address
440 W Ih 635 Fwy Ste 405
Irving, TX 75063
Phone
(972) 406-1199
Fax
(972) 556-2328
NPI assigned
Sep 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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 PA08579 TX Primary

Addresses

Primary practice location

440 W Ih 635 Fwy Ste 405
Irving, TX 75063

Mailing address

400 W Ih 635 Fwy
Suite 200
Irving, TX 75063-3718
Phone (972) 406-1199

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbachus218975@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
I20140304000896 TX Practitioner - Physician Assistant 4385874759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2005 W Park Dr
Irving, TX 75061-2034

2021 N Macarthur Boulevard
Irving, TX 75061-2210

400 W Lyndon B Johnson Fwy
Irving, TX 75063-3700

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor Scott & White Medical Center at Irving Hospital, Irving, TX, CCN 450079
  • 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
PA08579TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Nov 22, 2013 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

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

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

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

7217 Telecom Pkwy
Ste 100A
Garland, TX 75044
Phone (469) 800-2530

400 W Lyndon B Johnson Fwy
Ste 200
Irving, TX 75063
Phone (972) 406-1199

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

925 E Southlake Blvd
Ste 270
Southlake, TX 76092
Phone 2143582300 ext. 6225

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 3

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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1982030722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W IH 635 FWY",
            "address_2": "SUITE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633718",
            "telephone_number": "972-406-1199",
            "fax_number": "972-556-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W IH 635 FWY STE 405",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75063",
            "telephone_number": "972-406-1199",
            "fax_number": "972-556-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHUS",
        "first_name": "KRISTEN",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbachus218975@direct.sw.org",
            "affiliation": "N",
            "address_1": "440 W Ih 635 Fwy Ste 405",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.