Individual provider Active NPI

Tracy Linn Eisenhauer Dilley, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1215589726
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142209 Issued in TX
Practice address
1017 12TH Ave
Fort Worth, TX 76104-3915
Phone
(817) 334-2800
Fax
(817) 820-0094
NPI assigned
Jul 15, 2019
Last updated
Jul 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142209 TX Primary

Addresses

Primary practice location

1017 12TH Ave
Fort Worth, TX 76104-3915

Mailing address

1017 12TH Ave
Fort Worth, TX 76104-3915
Phone (817) 334-2800

Other practice location 1

920 Hilltop Dr
Weatherford, TX 76086-5488
Phone (817) 613-9082

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
I20190809000406 TX Practitioner - Nurse Practitioner 6204163520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2810
Phone (817) 252-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Oct 5, 2024 Accepting new patients
Fort Worth Heart, P.a. CurrentSince Apr 1, 2020 Accepting new patients
Texas Health Physicians Group CurrentSince Oct 5, 2024 Accepting new patients
Texas Health Physicians Group Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

1300 W Terrell Ave
Ste 420
Ft Worth, TX 76104
Phone (817) 250-6570

1300 W Terrell Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 252-5000

1900 Mistletoe Blvd
Ste 100
Ft Worth, TX 76104
Phone 8173381300236

1312 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-1855

Interoperability endpoints

  • Direct secure messaging: tdilley1661158@direct.texashealth.org

Organizations & group practices 5

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1215589726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 12TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043915",
            "telephone_number": "817-334-2800",
            "fax_number": "817-820-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 12TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043915",
            "telephone_number": "817-334-2800",
            "fax_number": "817-820-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Hilltop Dr",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760865488",
            "country_code": "US",
            "telephone_number": "817-613-9082",
            "fax_number": "817-820-0094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLEY",
        "first_name": "TRACY",
        "middle_name": "LINN EISENHAUER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.