SHAWN JILLIAN WALLER PA
NPI 1669192373
Physician Assistant in Dallas, TX

Q: What is Shawn Waller's NPI number?

The NPI number for Shawn Waller is 1669192373. It was assigned to this individual provider in the NPPES registry on September 1, 2022.

Q: What is Shawn Waller's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Shawn Waller was last updated on September 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since September 01, 2022PECOS EnrolledAccepts Medicare Assignment

6201 HARRY HINES BLVD, DALLAS, TX 75390(214) 633-5555 Get Directions Write a Review

NPPES record last updated: September 1, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Shawn Jillian Waller Pa NPPES

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

SHAWN JILLIAN WALLER PA (NPI 1669192373) is an individual physician assistant in Dallas, Texas and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, is affiliated with Ut Southwestern University Hospital - William P. Clements Jr., and is a graduate of Louisiana State University School Of Medicine In Shreveport (2022).

NPPES Registry Identity

NPI1669192373

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSHAWN JILLIAN WALLERCredential: PA

Location Address6201 HARRY HINES BLVDDallas, TX 75390-0001

Mailing Address1800 N Field St Apt 3305Dallas, TX 75202-2775 · (214) 893-8969

Phone(214) 633-5555

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 2022

Enumeration DateSeptember 1, 2022

NPPES CertifiedSeptember 1, 2022

✔ NPI 1669192373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

6201 HARRY HINES BLVD, Dallas, TX 75390

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shawn Jillian Waller Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749656791

PECOS Enrollment IDI20221017003324

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Southwestern University Hospital - William P. Clements Jr.

Acute Care Hospitals · Dallas, TX

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number450044

Location6201 Harry Hines BlvdDallas, TX 75390 · Dallas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75390 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

$71.28 typical visit price

range $18.48 – $141.20

Typical copayment $17.82 (range $4.62 – $35.30)

Most-billed visit code 99213

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.

ALVIN A CHANDRA M.D.

Internal Medicine (Cardiovascular Disease)