Individual provider Active NPI

Cassidy Rae Keshvani, PA-C

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1255710794
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA11301 Issued in TX
Practice address
5900 Altamesa Blvd Ste 100
Fort Worth, TX 76132-5473
Phone
(817) 854-9969
Fax
(817) 854-9965
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA11301 TX Primary

Addresses

Primary practice location

5900 Altamesa Blvd Ste 100
Fort Worth, TX 76132-5473

Mailing address

5900 Altamesa Blvd Ste 100
Fort Worth, TX 76132-5475
Phone (817) 854-9969

Other practice location 1

640 Keller Parkway Suite 100
Keller, TX 76248-2559
Phone (817) 854-9969

Other names 1

  • Cassidy Rae Davidson Former name

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
I20170814002589 TX Practitioner - Physician Assistant 4789997917 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
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

640 Keller Pkwy
Suite 100
Keller, TX 76248-2559
Phone (817) 854-9969

721 Keller Pkwy
Keller, TX 76248-2404
Phone (817) 854-9969

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Indiana Emergency Solutions LLC Past Accepting new patients
Ortholonestar, PLLC Past Accepting new patients
Ortholonestar, PLLC Past Accepting new patients
Emergency Care Associates of Indiana, LLC Physician Assistant PastSince Sep 1, 2019 Accepting new patients

Locations

8210 Walnut Hill Ln
Ste 130
Dallas, TX 75231
Phone (214) 750-1207

5900 Altamesa Blvd
Ste 100
Fort Worth, TX 76132
Phone (817) 854-9969

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

5701 Bryant Irvin Rd
Ste 302
Ft Worth, TX 76132
Phone (817) 294-9000

721 Keller Pkwy
Ste 107B
Keller, TX 76248
Phone (817) 741-8020

Interoperability endpoints

  • Direct secure messaging: cassidy.keshvani.1@15533.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1255710794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 ALTAMESA BLVD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325475",
            "telephone_number": "817-854-9969",
            "fax_number": "803-604-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 ALTAMESA BLVD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325473",
            "telephone_number": "817-854-9969",
            "fax_number": "817-854-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Keller Parkway Suite 100",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762482559",
            "country_code": "US",
            "telephone_number": "817-854-9969",
            "fax_number": "833-604-0854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KESHVANI",
        "first_name": "CASSIDY",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "DAVIDSON",
            "middle_name": "RAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.