Individual provider Active NPI

Alexandra J Hartke

  • Adult Health Nurse Practitioner
  • Frisco, TX
National Provider Identifier
1992283790
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP138315 Issued in TX
Practice address
5550 Warren Pkwy Ste 110
Frisco, TX 75034-7399
Phone
(469) 252-4777
Fax
(469) 518-2156
NPI assigned
Aug 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP138315 TX Primary

Addresses

Primary practice location

5550 Warren Pkwy Ste 110
Frisco, TX 75034-7399

Mailing address

5550 Warren Pkwy Ste 110
Frisco, TX 75034-7399
Phone (469) 252-4777

Other practice location 1

3805 Hawick Ln
Dallas, TX 75220-5016
Phone (419) 852-3494

Other practice location 2

6020 W Parker Rd
Plano, TX 75093-8171
Phone (469) 252-4777

Other identifiers 1

IdentifierTypeStateIssuer
AP138315OtherTXTEXAS BON

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
I20190708000508 TX Practitioner - Nurse Practitioner 4385979863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138315TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regen Pain Management, PLLC CurrentSince Mar 8, 2019 Accepting new patients
Regen Pain Management, PLLC CurrentSince Mar 8, 2019 Accepting new patients
United Ancillaries, PLLC PastSince May 30, 2018 Accepting new patients

Locations

5550 Warren Pkwy
Ste 110
Frisco, TX 75034
Phone (214) 440-1245

6020 W Parker Rd
Ste 300
Plano, TX 75093
Phone (469) 200-6461

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.

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1992283790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 WARREN PKWY STE 110",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347399",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WARREN PKWY STE 110",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347399",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3805 Hawick Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752205016",
            "country_code": "US",
            "telephone_number": "419-852-3494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6020 W Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938171",
            "country_code": "US",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTKE",
        "first_name": "ALEXANDRA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP138315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BON",
            "identifier": "AP138315",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.