Individual provider Active NPI

Philip Blanco Antiporta, M.D.

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1104139732
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
R8147 Issued in TX
Practice address
1325 Pennsylvania Ave Ste 350
Fort Worth, TX 76104-2172
Phone
(817) 887-9389
Fax
(817) 887-9392
NPI assigned
Jul 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X R8147 TX Primary
Infectious Disease Physician 207RI0200X 036.133199 IL

Addresses

Primary practice location

1325 Pennsylvania Ave Ste 350
Fort Worth, TX 76104-2172

Mailing address

PO Box 802772
Dallas, TX 75380-2772
Phone (972) 484-7700

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
I20190130000626 TX Practitioner - Infectious Disease 9739490699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Disease Doctors, PAGroup PAC ID 1557345774, 17 clinicians

Practice addresses (Care Compare)

1325 Pennsylvania Ave
Suite 350
Fort Worth, TX 76104-2172
Phone (817) 887-9389

Hospital & facility affiliations

  • The Home Health Team Home health agency, Richardson, TX, CCN 747573
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137

Merit-based Incentive Payment System (MIPS)

Final score
21.79 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
72.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.133199ILMDInfectious Disease Physician
R8147TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Doctors, PA Infectious Disease CurrentSince Feb 1, 2019 Accepting new patients

Locations

2636 Tibbets Dr
Ste 110
Bedford, TX 76022
Phone (817) 585-0065

1325 Pennsylvania Ave
Ste 325
Fort Worth, TX 76104
Phone (817) 878-5325

1325 Pennsylvania Ave
Ste 350
Ft Worth, TX 76104
Phone (817) 887-9389

2300 Marie Curie Dr
Garland, TX 75042
Phone (972) 487-5000

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

Interoperability endpoints

  • Direct secure messaging: pantiporta@iddoctors.ssdirect.aprima.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.

Hospital & facility affiliations 4

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": "1280016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1104139732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802772",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753802772",
            "telephone_number": "972-484-7700",
            "fax_number": "972-484-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 350",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042172",
            "telephone_number": "817-887-9389",
            "fax_number": "817-887-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIPORTA",
        "first_name": "PHILIP",
        "middle_name": "BLANCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-25",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "R8147",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036.133199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.