Individual provider Active NPI

Marlyn Solangel El-Diqran, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1992368484
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12708 Issued in TX
Practice address
2066 Augusta Dr
Houston, TX 77057-3751
Phone
(832) 795-8233
NPI assigned
Apr 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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 PA12708 TX Primary

Addresses

Primary practice location

2066 Augusta Dr
Houston, TX 77057-3751

Mailing address

2066 Augusta Dr
Houston, TX 77057-3751

Other names 1

  • Marlyn Solangel Davila Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20241029003854 WA Practitioner - Physician Assistant 3678806155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Associates, PLLCGroup PAC ID 0840196564, 3 clinicians

Practice addresses (Care Compare)

1345 King St
Bellingham, WA 98229-6223
Phone (360) 676-1696

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marlyn.el-diqran.1@1250.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1250/brand/1/csg/1/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.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1992368484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 AUGUSTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 AUGUSTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573751",
            "telephone_number": "832-795-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-DIQRAN",
        "first_name": "MARLYN",
        "middle_name": "SOLANGEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLYN",
            "last_name": "DAVILA",
            "middle_name": "SOLANGEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.