Individual provider Active NPI

Cindy L Atwell, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1073745428
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06119 Issued in TX
Practice address
9668 Bartlett Cir
Fort Worth, TX 76108-4467
Phone
(817) 900-8031
Fax
(817) 367-2417
NPI assigned
Aug 19, 2009
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06119 TX Primary

Addresses

Primary practice location

9668 Bartlett Cir
Fort Worth, TX 76108-4467

Mailing address

9668 Bartlett Cir
Fort Worth, TX 76108-4467
Phone (817) 900-8031

Other identifiers 1

IdentifierTypeStateIssuer
TXB150409OtherTXPTAN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090828000323 TX Practitioner - Physician Assistant 8527113448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Offices of Family Medicine PLLCGroup PAC ID 9335301266, 2 clinicians

Practice addresses (Care Compare)

9668 Bartlett Cir
Fort Worth, TX 76108-4467
Phone (817) 900-8031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1073745428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9668 BARTLETT CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084467",
            "telephone_number": "817-900-8031",
            "fax_number": "817-367-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9668 BARTLETT CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084467",
            "telephone_number": "817-900-8031",
            "fax_number": "817-367-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWELL",
        "first_name": "CINDY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "TXB150409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.