Active NPI
Anitta Varghese Thomas, PA-C
- Physician Assistant
- Dallas, TX
National Provider Identifier
1083270094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601009711
- Practice address
- 2360 Gus Thomasson Rd
Dallas, TX 75228-3005 - Phone
- (214) 396-0348
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601009711 | MI | Primary |
Addresses
Primary practice location
2360 Gus Thomasson Rd
Dallas, TX 75228-3005
Mailing address
4642 Shivers LN
Forney, TX 75126-3389
Other practice location 1
1901 N Telegraph Rd
Waterford, MI 48328-1878
Phone (248) 836-1000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2360 Gus Thomasson Rd
Dallas, TX 75228-3005
Phone (314) 301-7071
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- anitta.varghese@oakstreethealth.gwaydirect.com
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.
-
- Primary Care Clinic/Center
- Fort Worth, TX
- NPI 1497387419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1083270094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4642 SHIVERS LN",
"city": "FORNEY",
"state": "TX",
"postal_code": "751263389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 GUS THOMASSON RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752283005",
"telephone_number": "214-396-0348"
}
],
"practiceLocations": [
{
"address_1": "1901 N Telegraph Rd",
"address_purpose": "LOCATION",
"city": "Waterford",
"state": "MI",
"postal_code": "483281878",
"country_code": "US",
"telephone_number": "248-836-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "ANITTA",
"middle_name": "VARGHESE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601009711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.