Individual provider Active NPI

Gary Victor Bartholomew, D.P.M.

  • Foot Surgery Podiatrist
  • Fort Worth, TX
National Provider Identifier
1316077761
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
926 Issued in TX
Practice address
5450 Clearfork Main St Ste 220
Fort Worth, TX 76109-3562
Phone
(817) 505-0233
Fax
(817) 332-3172
NPI assigned
Mar 6, 2007
Last updated
Oct 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 926 TX Primary

Addresses

Primary practice location

5450 Clearfork Main St Ste 220
Fort Worth, TX 76109-3562

Mailing address

5450 Clearfork Main St Ste 410
Fort Worth, TX 76109-3559
Phone (817) 505-0233

Other practice location 1

909 9th Ave
Suite 300
Fort Worth, TX 76104-3903
Phone (817) 336-7191

Other identifiers 3

IdentifierTypeStateIssuer
0187254-01MedicaidTX
084933301OtherTXMEDICAID GROUP NUMBER
018725402MedicaidTX

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080522000266 TX Practitioner - Podiatry 6901975598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
926TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC CurrentSince Jul 15, 2008 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Jul 15, 2008 Accepting new patients
Medical Clinic of North Texas PLLC PastSince Oct 27, 2019 Accepting new patients
Wellmed Medical Group, PA PastSince Oct 27, 2019 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

5450 Clearfork Main St
Ste 220
Fort Worth, TX 76109
Phone (682) 707-4555

5450 Clearfork Main St
Ste 410
Fort Worth, TX 76109
Phone (817) 505-0233

909 9th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 336-7191

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • Direct secure messaging: gbartholomew@direct.uspi.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1316077761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 410",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093559",
            "telephone_number": "817-505-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093562",
            "telephone_number": "817-505-0233",
            "fax_number": "817-332-3172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 9th Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043903",
            "country_code": "US",
            "telephone_number": "817-336-7191",
            "fax_number": "817-877-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "GARY",
        "middle_name": "VICTOR",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TX",
            "license": "926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187254-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "084933301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018725402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.