Individual provider Active NPI

Metasebiya Kucha Dewele, FNP-BC

  • Family Nurse Practitioner
  • Rowlett, TX
National Provider Identifier
1124834957
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1180846 Issued in TX
Practice address
3714 Thornhill Way
Rowlett, TX 75088-6051
Phone
(469) 363-0429
NPI assigned
Dec 6, 2024
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1180846 TX Primary

Addresses

Primary practice location

3714 Thornhill Way
Rowlett, TX 75088-6051

Mailing address

3714 Thornhill Way
Rowlett, TX 75088-6051
Phone (469) 363-0429

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
I20250321000373 TX Practitioner - Nurse Practitioner 6103348982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perioperative and Transitional Medicine Group PLLCGroup PAC ID 7214245646, 34 clinicians

Practice addresses (Care Compare)

8220 Walnut Hill LN
Suite 600
Dallas, TX 75231-4433
Phone (214) 238-3074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1180846TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative and Transitional Medicine Group PLLC Family CurrentSince Mar 1, 2025 Accepting new patients

Locations

8220 Walnut Hill Ln
Ste 600
Dallas, TX 75231
Phone (214) 238-3074

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, 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": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1124834957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 THORNHILL WAY",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750886051",
            "telephone_number": "469-363-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 THORNHILL WAY",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750886051",
            "telephone_number": "469-363-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWELE",
        "first_name": "METASEBIYA",
        "middle_name": "KUCHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1180846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

Verify at the official NPI Registry.