Individual provider Active NPI

Jonathan W Sahawneh, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1356970123
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T6704 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-1244
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X TX
Family Medicine Physician 207Q00000X T6704 TX Primary
Family Medicine Physician 207Q00000X 01094270A IN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1244

Other practice location 1

253 Sagamore Pkwy W
Lafayette, IN 47906-1501
Phone (765) 448-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsahawneh@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240813000852 IN Practitioner - Family Practice 3274071949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

253 Sagamore Pkwy W
West Lafayette, IN 47906-1501
Phone (765) 448-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01094270AINMDFamily Medicine Physician
T6704TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC CurrentSince Sep 30, 2024 Accepting new patients
Arnett Clinic, LLC Single Specialty CurrentSince Sep 30, 2024 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Iu Health Medical Group, LLC Single Specialty CurrentSince Jan 1, 2026 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

2600 Greenbush St
Lafayette, IN 47904

253 Sagamore Pkwy W
West Lafayette, IN 47906

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.

Hospital & facility affiliations 2

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1356970123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 Sagamore Pkwy W",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479061501",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-4270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAHAWNEH",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T6704",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01094270A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsahawneh@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "253 Sagamore Pkwy W",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479061501",
            "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.