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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CAROLYN K FAN
NPI 1154018513
Emergency Medicine in Dallas, TX

Active since April 18, 2023PECOS Enrolled
3500 GASTON AVE, DALLAS, TX 75246(214) 820-0111 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carolyn K Fan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROLYN K FAN (NPI 1154018513) is an individual emergency medicine provider in Dallas, Texas, licensed in California (A206496) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154018513
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameCAROLYN K FAN
Location Address3500 GASTON AVEDallas, TX 75246-2088
Mailing Address5648 Auden StHouston, TX 77005-2008
Phone(214) 820-0111
Sole ProprietorYes
Enumeration DateApril 18, 2023
Last NPPES UpdateAugust 10, 2026
NPPES CertifiedAugust 10, 2026
✔ NPI 1154018513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in CA · A206496
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3500 GASTON AVE, Dallas, TX 75246
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn K Fan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75246 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAIME ALBERT CAMPBELL M.D., M.S.
Pathology (Anatomic Pathology & Clinical Pathology)
3500 GASTON AVE, BAYLOR UNIVERSITY MEDICAL CENTER, DEPT OF PATHOLOGY
DALLAS, TX 75246
Dallas County (214) 820-3772
MICHELLE CAIN AGACNP
Nurse Practitioner (Acute Care)
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 820-2050
DR. MATTHEW PAUL CLEMONS MD
Radiology (Diagnostic Radiology)
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 820-2361
ROBERT COLE FORE RN
Registered Nurse
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 820-0111
JAMES PIERRE D'ETIENNE MD
Emergency Medicine
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 820-2505
DR. JO ANN F. TRAVIS M.D.
Anesthesiology
3500 GASTON AVE, DEPARTMENT OF ANESTHESIOLOGY
DALLAS, TX 75246
Dallas County (214) 549-4835
ASIF ZIA KHATTAK MD
Pediatrics (Neonatal-Perinatal Medicine)
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 820-7604
FATIMA KHAN
Student in an Organized Health Care Education/Training Program
3500 GASTON AVE
DALLAS, TX 75246
Dallas County (844) 279-3627

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolyn Fan's NPI number?

The NPI number for Carolyn Fan is 1154018513. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Where is Carolyn Fan located?

Carolyn Fan practices at 3500 Gaston Ave, Dallas, TX 75246. The listed phone number is (214) 820-0111.

What is Carolyn Fan's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Carolyn Fan enrolled in Medicare?

Yes. Carolyn Fan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carolyn Fan was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.