Individual provider Active NPI

Anna Grace Buck, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1174278667
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17112 Issued in TX
Practice address
5751 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4131
Phone
(817) 923-8220
Fax
(817) 923-9004
NPI assigned
Feb 14, 2022
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17112 TX Primary
Physician Assistant 363A00000X 60678 CA

Addresses

Primary practice location

5751 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4131

Mailing address

5751 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4131
Phone (817) 923-8220

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

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
I20230918001366 TX Practitioner - Physician Assistant 2163809096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Molly M Warthan MDGroup PAC ID 7810203817, 5 clinicians

Practice addresses (Care Compare)

5751 Edwards Ranch Rd
Fort Worth, TX 76109-4131
Phone (817) 923-8220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60678CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine Past Accepting new patients
California Sports Physical Therapy Centers Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anna.buck.p2@direct.muirortho.nextgenshare.com
  • Direct secure messaging: anna.buck@8734917853188.direct.elationemr.com
  • Direct secure messaging: anna.woodford.p1@direct.orthonorcal.nextgenshare.com

Organizations & group practices 3

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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1174278667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094131",
            "telephone_number": "817-923-8220",
            "fax_number": "817-923-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094131",
            "telephone_number": "817-923-8220",
            "fax_number": "817-923-9004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ANNA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17112",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.