Individual provider Active NPI

Jason Fracchia, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1295324309
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
7630 N Beach St
Fort Worth, TX 76137-1299
Phone
(817) 370-9891
NPI assigned
Jan 13, 2021
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

7630 N Beach St
Fort Worth, TX 76137-1299

Mailing address

6501 Harris Pkwy
Fort Worth, TX 76132-6102
Phone (817) 370-9891

Other practice location 1

12457 Timberland Blvd Ste 205
Fort Worth, TX 76244-5211
Phone (817) 370-9891

Other identifiers 1

IdentifierTypeStateIssuer
3125994OtherTXTEMP PT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210224000740 TX Practitioner - Physical Therapist in Private Practice 7416362421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Baylor College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportherapy LLCGroup PAC ID 0749536308, 45 clinicians

Practice addresses (Care Compare)

7630 N Beach St
Suite 180
Fort Worth, TX 76137-3017
Phone (817) 428-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportherapy LLC Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients
Sportherapy Southwest, PC Physical Therapist PastSince Jan 17, 2021 Accepting new patients
Gateway Partners Inc Physical Therapist PastSince Dec 15, 2011 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

12457 Timberland Blvd
Ste 205
Fort Worth, TX 76244
Phone (682) 213-3006

7630 N Beach St
Ste 180
Fort Worth, TX 76137
Phone (682) 428-9900

7630 N Beach St
Ft Worth, TX 76137
Phone (817) 428-9900

8857 Davis Blvd
Ste 100
Keller, TX 76248
Phone (817) 413-8700

965 Hilltop Dr
Weatherford, TX 76086
Phone (817) 370-9891

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1295324309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326102",
            "telephone_number": "817-370-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 N BEACH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761371299",
            "telephone_number": "817-370-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12457 Timberland Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762445211",
            "country_code": "US",
            "telephone_number": "817-370-9891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRACCHIA",
        "first_name": "JASON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMP PT LICENSE",
            "identifier": "3125994",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.