Elena Noemi Noonan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14380 Issued in TX

Practice address

4324 Golden Triangle Blvd # 110
Fort Worth, TX 76244-6314

Phone

(972) 525-9900

Fax

(469) 333-7988

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX, MN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Form Health Associates Ma, P.C.Group PAC ID 3375953961, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: elena.noonan@168064768409604.direct.elationemr.com
• Direct secure messaging: elena.noonan.1@13711.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 and National Provider Directory roles.

• Form Health Associates Ma, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
  • NPI 1386260594

  TX

  Medicare reassignment Care Compare group
• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029
  Medicare reassignment Care Compare group
• Interventional Partners PLLC

  • Vascular & Interventional Radiology Physician
  • Addison, TX
  • NPI 1750814737
  NPD (past)

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1174041396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360541",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516541",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 GOLDEN TRIANGLE BLVD # 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446314",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6205 Westcreek Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761334326",
            "country_code": "US",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "ELENA",
        "middle_name": "NOEMI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "185050",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elena.noonan.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "6205 Westcreek Dr Ste 105",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761334326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elena.noonan.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "6205 Westcreek Dr Ste 105",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761334326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline Noftle
• Thelma Nondi Noland
• Alice Wade Noles, LCSW
• Thomas R Nolley Sr.
• Non Emergency Transport Inc.
• Anis R Noorani, D.C.
• Bethany Noelle Norberg, MD
• Jessica Nored
• Abigail Faith Norman, OTR
• Alan Andrew Norman, MD

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.