Individual provider Active NPI

Frederick Mario Oriti, PA-C

  • Physician Assistant
  • Granbury, TX
National Provider Identifier
1215030499
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02360 Issued in TX
Practice address
1308 Paluxy Rd Ste 300
Granbury, TX 76048-5689
Phone
(817) 579-3978
Fax
(817) 579-3977
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 PA02360 TX Primary

Addresses

Primary practice location

1308 Paluxy Rd Ste 300
Granbury, TX 76048-5689

Mailing address

1308 Paluxy Rd Ste 300
Granbury, TX 76048-5689
Phone (817) 579-3978

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address frederick.oriti.1@1293.direct.athenahealth.com

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
I20050621000258 TX Practitioner - Physician Assistant 8022053107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02360TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince Apr 1, 2012 Accepting new patients
Cook Children'S Physician Network CurrentSince Apr 1, 2012 Accepting new patients
My Health My Resources of Tarrant County Past Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1215030499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 PALUXY RD STE 300",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485689",
            "telephone_number": "817-579-3978",
            "fax_number": "817-579-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 PALUXY RD STE 300",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485689",
            "telephone_number": "817-579-3978",
            "fax_number": "817-579-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORITI",
        "first_name": "FREDERICK",
        "middle_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frederick.oriti.1@1293.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1308 Paluxy Rd Ste 300",
            "city": "Granbury",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760485689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.