NPIMap

Individual provider Active NPI

Molly Jane Boggs, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1154369155
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02341 Issued in TX
Practice address
600 S Main St Ste 3.500
Fort Worth, TX 76104-2410
Phone
(817) 882-2590
NPI assigned
Jun 2, 2006
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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 PA02341 TX Primary

Addresses

Primary practice location

600 S Main St Ste 3.500
Fort Worth, TX 76104-2410

Mailing address

600 S Main St Ste 3.500
Fort Worth, TX 76104-2410
Phone (817) 882-2590

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mboggs220154@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091022000691 TX Practitioner - Physician Assistant 0840337895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3000N Interstate 35
Denton, TX 76201-5119
Phone (469) 303-3591

5323 Harry Hines Blvd
Dallas, TX 75390-9257

600 S Main St
Fort Worth, TX 76104-2410

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 26, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 9, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince May 26, 2018 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 9, 2023 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

2210 N State Highway 360
Grand Prairie, TX 75050
Phone (972) 606-8300

2740 N State Highway 360
Ste 100
Grand Prairie, TX 75050
Phone (972) 606-8300

5220 W University Dr
Ste 100
McKinney, TX 75071
Phone (469) 800-5036

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mboggs220154@direct.sw.org

Organizations & group practices 9

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.

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1154369155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MAIN ST STE 3.500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042410",
            "telephone_number": "817-882-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MAIN ST STE 3.500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042410",
            "telephone_number": "817-882-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "MOLLY",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboggs220154@direct.sw.org",
            "affiliation": "N",
            "address_1": "5220 W University Dr Ste 100",
            "city": "McKinney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750717402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.