Individual provider Active NPI

Nisha Rathore, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1295179547
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S0367 Issued in TX
Practice address
1500 W Rosedale St
Fort Worth, TX 76104-7403
Phone
(682) 885-3426
Fax
(682) 885-7699
NPI assigned
Apr 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S0367 TX Primary

Addresses

Primary practice location

1500 W Rosedale St
Fort Worth, TX 76104-7403

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nrathore173881@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923000393 TX Practitioner - Pediatric Medicine 7214177443 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics Current Accepting new patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Oct 14, 2019 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Dec 2, 2022 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Dec 2, 2022 Accepting new patients

Locations

1500 W Rosedale St
Fort Worth, TX 76104
Phone (682) 885-3426

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

8233 N Sam Houston Pkwy E
Humble, TX 77396
Phone (713) 442-2000

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: nrathore173881@cookchildrens.direct-ci.com

Organizations & group practices 4

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1295179547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W ROSEDALE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047403",
            "telephone_number": "682-885-3426",
            "fax_number": "682-885-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHORE",
        "first_name": "NISHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S0367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrathore173881@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1500 W Rosedale St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761047403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.