Fasica Wondifraw

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP139847 Issued in TX

Practice address

1218 W McDermott Dr
Allen, TX 75013-6304

Phone

(972) 390-9000

NPI assigned

Mar 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Fasica Admasu Former name

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Prohealth

  • Physical Therapist
  • Coppell, TX
  • NPI 1033130828
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1245798214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136304",
            "telephone_number": "972-390-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136304",
            "telephone_number": "972-390-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONDIFRAW",
        "first_name": "FASICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FASICA",
            "last_name": "ADMASU",
            "credential": "FNP, APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wojnicki Global Chiropractic PA
• Michael Patrick Wojnicki, D.C.
• Christopher Neill Wolfe, RN
• Matthew Wolfe, DPT
• Women'S Medical Associates of North Texas
• On S Wong, D.C.
• Bailey Elizabeth Wood, FNP-C
• Jeffery B Wood
• Jeffery Brooks Wood Jr., O.D.
• Katy Jo Wood, NP-C

• Family Nurse Practitioner in Allen, TX
• Providers in Allen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.