Individual provider Active NPI

John Andrew Osborne, MD

  • Cardiovascular Disease Physician
  • Grapevine, TX
National Provider Identifier
1114929718
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
K4180 Issued in TX
Practice address
3801 William D Tate Ave Ste 850
Grapevine, TX 76051-8757
Phone
(817) 310-3070
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X K4180 TX Primary
Nuclear Cardiology Physician 207UN0901X K4180 TX

Addresses

Primary practice location

3801 William D Tate Ave Ste 850
Grapevine, TX 76051-8757

Mailing address

3801 William D Tate Ave Ste 850
Grapevine, TX 76051-8757
Phone (817) 310-3070

Other identifiers 3

IdentifierTypeStateIssuer
101963003MedicaidTX
101963004MedicaidTX
101963005MedicaidTX

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
I20070925000660 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Nuclear Medicine 0345293932 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Medical Physician Group CurrentSince Sep 1, 2014 Accepting new patients
Dallas Medical Physician Group Cardiovascular Disease CurrentSince Sep 1, 2014 Accepting new patients
State of the Heart Cardiology Current Accepting new patients
Physicians and Allied Health Professionals Group, PA Cardiovascular Disease Past Accepting new patients

Locations

3801 William D Tate Ave
Ste 850
Grapevine, TX 76051
Phone (817) 310-3070

5308 N Galloway Ave
Mesquite, TX 75150
Phone (972) 226-0505

Interoperability endpoints

  • Direct secure messaging: dmcjosbor@yourcarecommunity.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1114929718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 850",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518757",
            "telephone_number": "817-310-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 850",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518757",
            "telephone_number": "817-310-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K4180",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "K4180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101963003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101963004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101963005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.