Unknown Individual – Medical Physician Assistant, NPI 1477642767
Medical Physician Assistant
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NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4780, North Josey Lane, Carrollton, Denton County, Texas, 75010, United States
CARROLLTON, TX 750104615
Phone: (972) 492-1334
Fax: (972) 492-5174
Type: Mailing
Baylor Medical Pavilion, 3900, Junius Street, Old East Dallas, Dallas, Dallas County, Texas, 75214, United States
SUITE 500
DALLAS, TX 752461615
Phone: (214) 823-7090
Fax: (214) 823-1644
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 74 | 56 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 42 | 38 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 23 | 22 | $0 |
| 73610 | X-ray of ankle, minimum of 3 views | 22 | 20 | $0 |
| 73620 | X-ray of foot, 2 views | 13 | 12 | $0 |
Insurance plans in this area (ZIP 75010)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TX | 73630 | X-ray of foot, minimum of 3 views | 136 | 96 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | TX | |
| Nurse Practitioner | TX | |
| Internal Medicine | TX | |
| - | TX | |
| - | TX | |
| Clinical Social Worker | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Orthopedic Surgery | TX | |
| Clinical Psychologist | TX |
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