Wisam Nachawati, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

T1786 Issued in TX

Practice address

5224 S State Highway 360 Ste 230
Grand Prairie, TX 75052-0964

Phone

(972) 522-0691

Fax

(972) 522-1053

NPI assigned

Sep 3, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MedhealthGroup PAC ID 9931001567, 435 clinicians

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wnachawati178686@dm.mhd.com

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.

• Medhealth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  Medicare reassignment Care Compare group NPD
• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Medhealth

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Mansfield, TX
  • NPI 1689629941
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1043644537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5224 S STATE HIGHWAY 360 STE 230",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520964",
            "telephone_number": "972-522-0691",
            "fax_number": "972-522-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5224 S STATE HIGHWAY 360 STE 230",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520964",
            "telephone_number": "972-522-0691",
            "fax_number": "972-522-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACHAWATI",
        "first_name": "WISAM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T1786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.