Paulina Purnama, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11021 Issued in TX

Practice address

800 12TH Ave Ste 200
Fort Worth, TX 76104-2519

Phone

(214) 631-9881

Fax

(469) 482-2526

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southlake Orthopedics and Sports Medicine PLLCGroup PAC ID 8426313131, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adaptive Home Health Home health agency, Temple, TX, CCN 458194
• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Baylor Medical Center at Trophy Club Hospital, Trophy Club, TX, CCN 450883
• Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085
• Methodist Southlake Medical Center Hospital, Southlake, TX, CCN 670132

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HCGHDD/Endpoint/HCGHDD
• Direct secure messaging: paulina.purnama@iasm-tx.direct.office.nextgen.com

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.

• Southlake Orthopedics & Sports Medicine, PLLC

  dba Summit Orthopedics of Texas

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1871099739
  Medicare reassignment Care Compare group
• Doctx3 PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1467808618
  Medicare reassignment NPD
• Elite PA Surgical Assists, PLLC

  • Orthopaedic Surgery Physician
  • Southlake, TX
  • NPI 1346767431
  NPD Authorized official
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment
• Precision Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1538257621
  Medicare reassignment
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD
• Precision Orthopedics & Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Fort Worth, TX
  • NPI 1881454163
  NPD
• Southlake Orthopedics & Sports Medicine, PLLC

  • Orthopaedic Surgery Physician
  • Keller, TX
  • NPI 1740162726
  NPD
• Doctx3 PLLC

  • Durable Medical Equipment & Medical Supplies
  • Denton, TX
  • NPI 1235792169
  NPD (past)
• Scott a Welsh MD PA

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1952580425
  NPD (past)
• Orthoconnecticut, PLLC

  • Orthopaedic Surgery Physician
  • Danbury, CT
  • NPI 1770507345
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Hospitals of Dallas

  dba Methodist Southlake Medical Center

  • General Acute Care Hospital
  • Southlake, TX
  • NPI 1568818417
  Care Compare affiliation
• SHH-Standards Home Health Inc

  dba Adaptive Home Health

  • Home Health Agency
  • Temple, TX
  • NPI 1427206549
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Alliance

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1215296884
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation
• Trophy Club Medical Center LP

  dba Baylor Scott & White Medical Center - Trophy Club

  • General Acute Care Hospital
  • Trophy Club, TX
  • NPI 1982609558
  Care Compare affiliation

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1275724981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 12TH AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042519",
            "telephone_number": "214-631-9881",
            "fax_number": "469-482-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 12TH AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042519",
            "telephone_number": "214-631-9881",
            "fax_number": "469-482-2526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 Keller Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762481620",
            "country_code": "US",
            "telephone_number": "214-631-9881",
            "fax_number": "469-482-2526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURNAMA",
        "first_name": "PAULINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Purdy, LPC
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• Purevoice Therapy PLLC
• Isha Puri, M.D.
• Sophie Clarke Purke, CNS
• Clendon Henry Purnell Jr., LPC
• Purple Amphibian, LLC
• Purple Hearts Transportation LLC
• Purpose of Life Homecare
• Colton Purscell, DC

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2025; 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.