Individual provider Active NPI

Samantha Rene Evans, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1225900889
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1025 College Ave
Fort Worth, TX 76104-3013
Phone
(817) 810-9810
Fax
(817) 810-9815
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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 TX Primary

Addresses

Primary practice location

1025 College Ave
Fort Worth, TX 76104-3013

Mailing address

1025 College Ave
Fort Worth, TX 76104-3013
Phone (817) 810-9810

Other practice location 1

3410 Worth St Ste 780
Dallas, TX 75246-2003
Phone (214) 716-0662

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
I20260213001846 TX Practitioner - Physician Assistant 8921588583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in New Orleans, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Centers for Infectious Disease Associates PAGroup PAC ID 4880596451, 17 clinicians

Practice addresses (Care Compare)

1025 College Ave
Fort Worth, TX 76104-3013
Phone (817) 810-9810

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Centers for Infectious Disease Associates PA CurrentSince Oct 13, 2025 Accepting new patients
Tarrant County Infectious Disease Associates PastSince Oct 6, 2019 Accepting new patients

Locations

3410 Worth St
Ste 780
Dallas, TX 75246
Phone (817) 810-9810

1025 College Ave
Fort Worth, TX 76104
Phone (817) 810-9810

1125 College Ave
Ft Worth, TX 76104
Phone (817) 336-1640

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCCBBA

Organizations & group practices 2

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": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1225900889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-810-9810",
            "fax_number": "817-810-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-810-9810",
            "fax_number": "817-810-9815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3410 Worth St Ste 780",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462003",
            "country_code": "US",
            "telephone_number": "214-716-0662",
            "fax_number": "972-791-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SAMANTHA",
        "middle_name": "RENE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.