Individual provider Active NPI

Mary Annabelle Ribaudo, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1144029125
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
800 8TH Ave Ste 206
Fort Worth, TX 76104-2619
Phone
(817) 529-9199
NPI assigned
Mar 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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 Primary

Addresses

Primary practice location

800 8TH Ave Ste 206
Fort Worth, TX 76104-2619

Mailing address

800 8TH Ave Ste 206
Fort Worth, TX 76104-2619
Phone (817) 529-9199

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
I20250911001223 TX Practitioner - Physician Assistant 8022511500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Texas HSC, College of Osteopathic Med, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MP Plastic Surgery PLLCGroup PAC ID 1254681844, 9 clinicians

Practice addresses (Care Compare)

800 8TH Ave
Suite 206
Fort Worth, TX 76104-2619
Phone (817) 529-9199

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mary.ribaudo.1@29858.direct.athenahealth.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 1

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": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1144029125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042619",
            "telephone_number": "817-529-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042619",
            "telephone_number": "817-529-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBAUDO",
        "first_name": "MARY",
        "middle_name": "ANNABELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.