Michael Evans Sangenito, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14072 Issued in TX

Practice address

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124

Phone

(817) 423-2329

Fax

(817) 423-2663

NPI assigned

Oct 28, 2020

Last updated

Jan 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael H Boothby, MD, PAGroup PAC ID 0446426134, 12 clinicians

Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Merit-based Incentive Payment System (MIPS)

Final score

77.11 of 100Reported as group

Quality

55.05

Promoting interoperability

100

Improvement activities

40

Cost

68.65

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Michael H Boothby, MD PA

  dba The Orthopedic and Sports Medicine Institute

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1871878876
  Medicare reassignment Care Compare group
• Woodlands Pain Consultants,PA

  • Specialist
  • Spring, TX
  • NPI 1811090376

  Single Specialty

  NPD (past)

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

• Texas Health Huguley, Inc

  dba Texas Health Huguley Hospital Fort Worth South

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1518355759
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Texas Health Huguley Hospital Fort Worth South

  • General Acute Care Hospital
  • Burleson, TX
  • NPI 1033120423
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Huguley Memorial Medical Center

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1548273881
  Care Compare affiliation

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1285234377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-423-2329",
            "fax_number": "817-423-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGENITO",
        "first_name": "MICHAEL",
        "middle_name": "EVANS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14072",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA14072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msangenito@direct.osmifw.com",
            "affiliation": "N",
            "address_1": "2901 Acme Brick Plz",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761094124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madalyn Sanford
• Rafe Sanford
• Sue Ann Sanford, O.D.
• Nancy Sang
• Sangameshwar P Reddy MD PA
• Ishwara R Sankara, MD
• Balamurugan Ponniah Sankarapandian, M.D.
• Ponniah S Sankarapandian, MD
• Joseph Sansanelli Jr., O.D.
• Elizabeth Ashley Sansone

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.