CENTERWELL SENIOR PRIMARY CARE-NORTH BUCKNER
NPI 1649919929
Internal Medicine in Dallas, TX

Active since June 03, 2022CLIA 45D2265778 · Waiver
3312 N BUCKNER BLVD STE 213, DALLAS, TX 75228(469) 998-0720(877) 692-4919 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Centerwell Senior Primary Care-north Buckner NPPES

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

CENTERWELL SENIOR PRIMARY CARE-NORTH BUCKNER (NPI 1649919929) is a healthcare organization registered as an internal medicine in Dallas, Texas and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through August 1, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1649919929
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (TX) PA
Location Address3312 N BUCKNER BLVD STE 213Dallas, TX 75228-5642
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Fax(877) 692-4919
Organization SubpartYesParent: Centerwell Senior Primary Care Tx Pa
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJune 3, 2022
Last NPPES UpdateOctober 18, 2022
NPPES CertifiedOctober 18, 2022
✔ NPI 1649919929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
3312 N BUCKNER BLVD STE 213, Dallas, TX 75228

Other Names 1

Doing Business AsCenterwell Senior Primary Care-north Buckner

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Centerwell Senior Primary Care-north Buckner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

156

Medicare enrollment records show 156 clinicians reassign Medicare billing to Centerwell Senior Primary Care-North Buckner, which bills Medicare for the services they deliver. Of these, 13 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Nurse Practitioner65
Family Practice43
Internal Medicine30
Cardiovascular Disease (Cardiology)15
Cardiac Electrophysiology1
Clinical Social Worker1
Geriatric Medicine1

Nearest to this location (20)

See all 156
Nurse Practitioner
NPI 1780210492
3312 N BUCKNER BLVD STE 213
Dallas, TX 75228
(469) 998-0720
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1366071284
3312 N BUCKNER BLVD STE 213
Dallas, TX 75228
(469) 949-2842
✔ PECOS✔ Accepts Medicare0.1 mi
Internal Medicine
NPI 1184659187
10405 E NORTHWEST HWY STE 100
Dallas, TX 75238
(214) 321-6485
✔ PECOS✔ Accepts Medicare4.3 mi
Nurse Practitioner
NPI 1487072468
1205 NORTHWEST HWY
Garland, TX 75041
(469) 936-0541
✔ PECOS✔ Accepts Medicare4.5 mi
Family Practice
NPI 1801870449
9202 ELAM RD SOUTHEAST DALLAS HEALTH CENTER
Dallas, TX 75217
(214) 266-1600
✔ PECOS✔ Accepts Medicare6.2 mi
Nurse Practitioner
NPI 1639695497
8440 WALNUT HILL LN STE 700
Dallas, TX 75231
(214) 361-3300
✔ PECOS✔ Accepts Medicare6.9 mi
Internal Medicine
NPI 1144783838
9201 N CENTRAL EXPY STE 230
Dallas, TX 75231
(214) 233-6479
✔ PECOS✔ Accepts Medicare7.0 mi
Family Practice
NPI 1205865722
2601 FOREST LN
Garland, TX 75042
(972) 272-1632
✔ PECOS✔ Accepts Medicare7.1 mi
Nurse Practitioner
NPI 1932983772
3701 W NORTHWEST HWY STE 191
Dallas, TX 75220
(469) 606-9590
✔ PECOS✔ Accepts Medicare7.6 mi
Nurse Practitioner
NPI 1538618293
3701 W NORTHWEST HWY STE 191
Dallas, TX 75220
(469) 606-9590
✔ PECOS✔ Accepts Medicare7.6 mi
Internal Medicine
NPI 1568896967
1332 S PLANO RD STE 550
Richardson, TX 75081
(972) 619-3988
✔ PECOS✔ Accepts Medicare8.8 mi
Internal Medicine
NPI 1548243538
1936 AMELIA CT SENIOR HOUSE CALLS- SUPPORT BLDG C
Dallas, TX 75235
(214) 590-0409
✔ PECOS✔ Accepts Medicare8.9 mi
Family Practice
NPI 1770591414
1235 E BELT LINE RD STE 100
Richardson, TX 75081
(972) 671-3300
✔ PECOS✔ Accepts Medicare9.7 mi
Internal Medicine
NPI 1952539678
1005 W RALPH HALL PKWY STE 137
Rockwall, TX 75032
(972) 463-2001
✔ PECOS✔ Accepts Medicare14 mi
Internal Medicine
NPI 1821094335
416 VILLAGE DR STE C
Murphy, TX 75094
(972) 325-8060
✔ PECOS✔ Accepts Medicare14 mi
Family Practice
NPI 1033798715
3209 W CAMP WISDOM RD
Dallas, TX 75237
(469) 966-9660
✔ PECOS✔ Accepts Medicare15 mi
Nurse Practitioner
NPI 1003168857
3209 W CAMP WISDOM RD
Dallas, TX 75237
(469) 966-9660
✔ PECOS✔ Accepts Medicare15 mi
Internal Medicine
NPI 1447690490
951 W BELT LINE RD STE 100
Desoto, TX 75115
(972) 734-8092
✔ PECOS✔ Accepts Medicare19 mi
Family Practice
NPI 1437600624
725 W PIONEER PKWY
Grand Prairie, TX 75051
(945) 899-0770
✔ PECOS✔ Accepts Medicare19 mi
Family Practice
NPI 1992062160
820 S CARRIER PKWY
Grand Prairie, TX 75051
(972) 262-1425
✔ PECOS✔ Accepts Medicare20 mi
See all 156 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2265778

Centerwell Senior Primary Care - North Buckner · Dallas, TX
Active · expires Aug 1, 2028
CLIA Number45D2265778
Laboratory TypePhysician Office
Certificate Effective DateAugust 2, 2026
Certificate Expiration DateAugust 1, 2028
Laboratory DirectorAn Thien Tang
Laboratory Phone(469) 998-0720
Laboratory LocationCenterwell Senior Primary Care - North Buckner3312 N Buckner Blvd Suite 213, Dallas, TX 75228
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Centerwell Senior Primary Care (tx) PA's NPI number?

The NPI number for Centerwell Senior Primary Care (tx) PA is 1649919929. It was assigned to this organization in the NPPES registry on June 3, 2022. The provider is doing business as Centerwell Senior Primary Care-North Buckner.

Where is Centerwell Senior Primary Care (tx) PA located?

Centerwell Senior Primary Care (tx) PA is located at 3312 N Buckner Blvd Ste 213, Dallas, TX 75228. The listed phone number is (469) 998-0720.

What is Centerwell Senior Primary Care (tx) PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Centerwell Senior Primary Care (tx) PA enrolled in Medicare?

Yes. Centerwell Senior Primary Care (tx) PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centerwell Senior Primary Care (tx) PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 156 clinicians in 7 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care (tx) PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (65), Family Practice (43) and Internal Medicine (30). Of these, 13 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Centerwell Senior Primary Care (tx) PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2265778) is associated with this NPI, valid through August 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care (tx) PA was last updated on October 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.