Individual provider Active NPI

Chiazo S Amene, MD, FAANS

  • Neurological Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1245435056
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2014010397 Issued in MO
Practice address
909 9TH Ave Ste 201
Fort Worth, TX 76104-3916
Phone
(817) 870-5094
NPI assigned
Jun 20, 2007
Last updated
Jul 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2014010397 MO Primary

Addresses

Primary practice location

909 9TH Ave Ste 201
Fort Worth, TX 76104-3916

Mailing address

909 9TH Ave Ste 201
Fort Worth, TX 76104-3916
Phone (817) 870-5094

Other identifiers 1

IdentifierTypeStateIssuer
1245435056MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140820001706 MO Practitioner - Neurosurgery 0446478291 Reassigns benefits to 2 organizations
I20240118000284 TX Practitioner - Neurosurgery 0446478291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgical Associates of North Texas PLLCGroup PAC ID 8921234832, 14 clinicians

Practice addresses (Care Compare)

909 9TH Ave
Suite 201
Fort Worth, TX 76104-3916
Phone (817) 870-5094

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates of North Texas PLLC Neurological Surgery CurrentSince Jan 1, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 7, 2015 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Oct 10, 2014 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Oct 10, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

909 9th Ave
Ste 201
Fort Worth, TX 76104
Phone (214) 575-5885

Interoperability endpoints

  • Direct secure messaging: camene488815@directb.mercy.net

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, 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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1245435056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 9TH AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043916",
            "telephone_number": "817-870-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 9TH AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043916",
            "telephone_number": "817-870-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENE",
        "first_name": "CHIAZO",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD, FAANS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2014010397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245435056",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.