Individual provider Active NPI

Jonathan L. Ives, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1225412356
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09865 Issued in TX
Practice address
1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone
(817) 335-5288
Fax
(817) 338-0927
NPI assigned
Jul 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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 PA09865 TX Primary

Addresses

Primary practice location

1201 Fairmount Ave
Fort Worth, TX 76104-4215

Mailing address

911 Medical Centre Dr Ste C
Arlington, TX 76012-4758
Phone (817) 263-5864

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
I20151009002148 TX Practitioner - Physician Assistant 6507174695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Pulmonary and Critical Care Consultants PAGroup PAC ID 0840198818, 57 clinicians

Practice addresses (Care Compare)

1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone (817) 335-5288

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Medical City Arlington Hospital, Arlington, TX, CCN 450675
  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

Merit-based Incentive Payment System (MIPS)

Final score
92.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Care Providers, Inc. PastSince Apr 23, 2023 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1225412356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MEDICAL CENTRE DR STE C",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124758",
            "telephone_number": "817-263-5864",
            "fax_number": "817-263-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FAIRMOUNT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044215",
            "telephone_number": "817-335-5288",
            "fax_number": "817-338-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "JONATHAN",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.