NPIMap

Individual provider Active NPI

Danny Fillip, PA-C

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1992745053
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04061 Issued in TX
Practice address
1402 Rice Rd Ste 100
Tyler, TX 75703-3230
Phone
(903) 630-7691
NPI assigned
Jun 7, 2006
Last updated
Mar 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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 PA04061 TX Primary

Addresses

Primary practice location

1402 Rice Rd Ste 100
Tyler, TX 75703-3230

Mailing address

1402 Rice Rd Ste 100
Tyler, TX 75703-3230
Phone (903) 630-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000628 TX Practitioner - Physician Assistant 0244299758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Bradley Clinic of Texas PLLCGroup PAC ID 3577869015, 4 clinicians

Practice addresses (Care Compare)

1402 Rice Rd
Suite 100
Tyler, TX 75703-3230
Phone (903) 630-7691

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Medical Center Healthcare Associates Past Accepting new patients
East Texas Medical Center Athens Past Accepting new patients
East Texas Medical Center Healthcare Associates Past Accepting new patients
Smith Emergency Medicine Associates PA Past Accepting new patients
Ellis Emergency Physicians PLLC Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1992745053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 RICE RD STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033230",
            "telephone_number": "903-630-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 RICE RD STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033230",
            "telephone_number": "903-630-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLIP",
        "first_name": "DANNY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.