Individual provider Active NPI

Suzana M Jensen, DO

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1215674106
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V7537 Issued in TX
Practice address
1263 W Rosedale St Ste 200
Fort Worth, TX 76104-2837
Phone
(817) 336-4896
Fax
(817) 332-2805
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X V7537 TX Primary

Addresses

Primary practice location

1263 W Rosedale St Ste 200
Fort Worth, TX 76104-2837

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Other names 1

  • Suzana Marie Signaigo Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjensen235403@CookChildrens.direct-ci.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801000923 TX Practitioner - Pediatric Medicine 9537549357 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
V7537TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 25, 2025 Accepting new patients
Cook Children'S Physician Network Pediatrics Current Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 25, 2025 Accepting new patients
Cook Children'S Medical Center PastSince Jul 13, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince May 1, 2022 Accepting new patients
Radiology Associates of North Texas PA PastSince Jul 13, 2025 Accepting new patients

Locations

1263 W Rosedale St
#Forth
Fort Worth, TX 76104
Phone (817) 336-4896

1401 W Pulaski St
Fort Worth, TX 76104
Phone (682) 885-8012

7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163

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

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: sjensen235403@cookchildrens.direct-ci.com

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1215674106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 W ROSEDALE ST STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042837",
            "telephone_number": "817-336-4896",
            "fax_number": "817-332-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SUZANA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V7537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjensen235403@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1263 W Rosedale St Ste 200",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZANA",
            "last_name": "SIGNAIGO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.