Individual provider Active NPI

Heather Lea Branstetter, MD

  • Gastroenterology Physician
  • Ft Worth, TX
National Provider Identifier
1023153103
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R5247 Issued in TX
Practice address
6317 Harris Pkwy Ste 300
Ft Worth, TX 76132-4258
Phone
(817) 361-6900
Fax
(817) 522-1968
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6149 AK
Pediatrics Physician 208000000X MD4336 AK
Gastroenterology Physician 207RG0100X R5247 TX Primary

Addresses

Primary practice location

6317 Harris Pkwy Ste 300
Ft Worth, TX 76132-4258

Mailing address

6317 Harris Pkwy Ste 300
Ft Worth, TX 76132-4258
Phone (817) 361-6900

Other identifiers 1

IdentifierTypeStateIssuer
1014965MedicaidAK

Other names 1

  • Heather Lea Woller Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180801000924 TX Practitioner - Gastroenterology 4789777681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Louisville School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

505 S Nolen Dr
A
Southlake, TX 76092-9167
Phone (817) 424-1525

Hospital & facility affiliations

  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy66
Upper gastrointestinal (GI) endoscopy for acid reflux76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD4336AKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince May 17, 2018 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince May 17, 2018 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients
Northern Hospital Associates LLC PastSince Jan 1, 2013 Accepting new patients

Locations

6317 Harris Pkwy
Ste 300
Ft Worth, TX 76132
Phone (817) 361-6900

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

505 S Nolen Dr
#A
Southlake, TX 76092
Phone (817) 424-1525

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1023153103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6317 HARRIS PKWY STE 300",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761324258",
            "telephone_number": "817-361-6900",
            "fax_number": "817-522-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6317 HARRIS PKWY STE 300",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761324258",
            "telephone_number": "817-361-6900",
            "fax_number": "817-522-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSTETTER",
        "first_name": "HEATHER",
        "middle_name": "LEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "6149",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "MD4336",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "R5247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014965",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WOLLER",
            "middle_name": "LEA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.