Anthony Omokheowa Anani, MD, MPH, MBA
Individual provider Active NPI Pediatric Gastroenterology Physician · Prosper, TX
NPI 1255656708 · NPPES record last updated Apr 13, 2021
Key facts
- NPI
- 1255656708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Gastroenterology Physician 2080P0206X
- License
- Q7135 (TX)
- Practice address
- 4200 W University Dr
Prosper, TX 75078-9805 - Phone
- (682) 303-4200
- Fax
- (682) 303-4242
- NPI assigned
- Mar 28, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cook Childrens Physician Network
Practice addresses (Care Compare)
1500 Cooper St
Fort Worth, TX 76104-2710
Phone (682) 885-4007
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190320003198 | TX | Practitioner - Pediatric Medicine |
2466677760 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.12088 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children'S Physician Network | Pediatrics | Current |
Accepting new patients |
| Cook Children'S Physician Network | Pediatrics | Current |
Accepting new patients |
Locations
7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500
4200 W University Dr
Prosper, TX 75078
Phone (682) 303-4200
136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412
Interoperability endpoints
- aanani102021@cookchildrens.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.12088 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Gastroenterology Physician | 2080P0206X | Q7135 | TX | Yes |
Addresses
Primary practice location
4200 W University Dr
Prosper, TX 75078-9805
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aanani102021@CookChildrens.direct-ci.com |
Other providers in Prosper, TX
- Mouhammad Rateb Alwazeer
- Andrea Celeste Amaya
- Amanda Kay Ambrosy
- Sheena Amir
- Nejay Pauline Ananaba
- Keerthi Ananthula
- Jennifer Anderson
- Andrea Nemit LLC
- Tamara Antonino
- Apex Medical Group, PLLC
All providers in Prosper, TX · Pediatric Gastroenterology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.