Individual provider Active NPI

Sonya Amratlal Tanna, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1316246424
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6600 Bryant Irvin Rd
Fort Worth, TX 76132
Phone
(817) 820-0011
Fax
(817) 820-0073
NPI assigned
Mar 16, 2011
Last updated
Oct 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

6600 Bryant Irvin Rd
Fort Worth, TX 76132

Mailing address

6600 Bryant Irvin Rd
Fort Worth, TX 76132
Phone (817) 820-0011

Other identifiers 2

IdentifierTypeStateIssuer
2035487-02MedicaidTX
2838617-02MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000462 TX Practitioner - Physician Assistant 6002084878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology PA PastSince May 15, 2022 Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients
Philip Brown, MD, PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: stanna@directaddress.net

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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1316246424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-820-0011",
            "fax_number": "817-820-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-820-0011",
            "fax_number": "817-820-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNA",
        "first_name": "SONYA",
        "middle_name": "AMRATLAL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035487-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2838617-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.