Melissa Ann Poole-Dubin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1073764 Issued in TX

Practice address

1400 8TH Ave
Fort Worth, TX 76104-4110

Phone

(605) 415-5834

NPI assigned

May 17, 2022

Last updated

May 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.54 of 100Reported as group

Quality

92.07

Promoting interoperability

83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissa.poole-dubin.1@20300.direct.athenahealth.com

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Nto Physician Partners, PLLC

  dba North Texas Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Grapevine, TX
  • NPI 1306914312

  Single Specialty

  Medicare reassignment NPD
• Nto Physician Partners, PLLC

  • Orthopaedic Surgery Physician
  • Grapevine, TX
  • NPI 1114443181
  NPD
• Ut Physicians

  dba UT Health Services

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1144967605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 CLAIRBORNE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778204",
            "telephone_number": "605-415-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "605-415-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE-DUBIN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1073764",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "prescription, medical records,",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "1400 8th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jared Ponce
• Kenneth C Ponitz, D.O.
• Tonya Ponson
• Anna-Alicia Pool, CPNP
• Kathryn Ann Pool, M.S., CCC-SLP
• Alisha Poonawala, O.D.
• Patricia Poort, PTA
• Dabney Poorter, FNP-C
• Aaron Pope, MD
• Kylie D Pope, SLP-INTERN

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.