Individual provider Active NPI

Matthew J Dahle, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1336709393
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141938 Issued in TX
Practice address
1350 S Main St Ste 1250
Fort Worth, TX 76104
Phone
(817) 702-8400
Fax
(817) 702-4670
NPI assigned
Jun 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP141938 TX Primary

Addresses

Primary practice location

1350 S Main St Ste 1250
Fort Worth, TX 76104

Mailing address

PO Box 732973
Dallas, TX 75373-2973
Phone (817) 702-2450

Other practice location 1

5908 Winifred Dr
Fort Worth, TX 76133-2710
Phone (817) 269-0567

Other practice location 2

5908 Winifred Dr
Fort Worth, TX 76133-2710
Phone (817) 269-0567

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
I20191018001023 TX Practitioner - Nurse Practitioner 0749511954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1250 8TH Ave
Suite 515
Fort Worth, TX 76104-4130
Phone (817) 922-9968

Hospital & facility affiliations

  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Sep 23, 2019 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

1250 8th Ave
Ste 650
Fort Worth, TX 76104
Phone (817) 912-9180

1350 S Main St
Ste 1250
Fort Worth, TX 76104
Phone (817) 702-8400

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1250 8th Ave
Ste 515
Fort Worth, TX 76104
Phone (817) 922-4675

Interoperability endpoints

  • Direct secure messaging: mdahle1101562@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1336709393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732973",
            "telephone_number": "817-702-2450",
            "fax_number": "817-702-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S MAIN ST STE 1250",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-702-8400",
            "fax_number": "817-702-4670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5908 Winifred Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761332710",
            "country_code": "US",
            "telephone_number": "817-269-0567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5908 Winifred Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761332710",
            "country_code": "US",
            "telephone_number": "817-269-0567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHLE",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.