Active NPI
Josef Widerhorn, M.D.
- Cardiovascular Disease Physician
- Fort Worth, TX
National Provider Identifier
1053502583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- J2843
- Practice address
- 1307 8TH Ave Ste 501
Fort Worth, TX 76104-4143 - Phone
- (817) 922-9050
- NPI assigned
- Aug 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | J2843 | TX | |
| Cardiovascular Disease Physician | 207RC0000X | J2843 | TX | Primary |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | J2843 | TX | |
| Interventional Cardiology Physician | 207RI0011X | J2843 | TX |
Addresses
Primary practice location
1307 8TH Ave Ste 501
Fort Worth, TX 76104-4143
Mailing address
PO Box 12229
Fort Worth, TX 76110-8229
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85K247 | Other | TX | BLUE CROSS (HARRIS HOSP) |
| 2837065-007 | Other | TX | CIGNA PPO |
| 2837065-012 | Other | TX | CIGNA HMO |
| E51105 | Other | TX | TRICARE (HARRIS HOSP) |
| 2500101 | Other | TX | UNITED HEALTHCARE |
| 4236959 | Other | TX | AETNA PPO |
| 80420Y | Other | TX | BLUE CROSS BLUE SHIELD |
| 85K247 | Other | TX | MEDICARE PIN (HARRIS HOSP |
| 60055861 | Other | TX | RAILROAD MEDICARE |
| 2171076 | Other | TX | ATNA HMO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040908001183 | TX | Practitioner - Cardiovascular Disease (Cardiology) | 0345215950 | Practice locations: Fort Worth, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J2843 | TX | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Heart Clinic PA | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Cardiac Electrophysiology Physician
- Fort Worth, TX
- NPI 1982784195
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1053502583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12229",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761108229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 8TH AVE STE 501",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044143",
"telephone_number": "817-922-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDERHORN",
"first_name": "JOSEF",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-08",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "J2843",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "J2843",
"primary": true
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "TX",
"license": "J2843",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "TX",
"license": "J2843",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS (HARRIS HOSP)",
"identifier": "85K247",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PPO",
"identifier": "2837065-007",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HMO",
"identifier": "2837065-012",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE (HARRIS HOSP)",
"identifier": "E51105",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2500101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4236959",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "80420Y",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN (HARRIS HOSP",
"identifier": "85K247",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "60055861",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATNA HMO",
"identifier": "2171076",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.