Individual provider Active NPI

Corey R Segars, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1366603565
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04889 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 735-2400
NPI assigned
Jun 19, 2008
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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 PA04889 TX Primary

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-0335

Other identifiers 4

IdentifierTypeStateIssuer
199957501MedicaidTX
P01527358OtherTXRAILROAD MEDICARE
8539NFOtherTXBCBS
199957508MedicaidTX

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
I20080815000573 TX Practitioner - Physician Assistant 1355416959 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Health My Resources of Tarrant CountyGroup PAC ID 6406755693, 44 clinicians

Practice addresses (Care Compare)

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 927-3636

3124 SE Loop
Suite 820
Fort Worth, TX 76140-1031
Phone (817) 569-4300

3840 Hulen St
Fort Worth, TX 76107-7277
Phone (817) 569-4300

Merit-based Incentive Payment System (MIPS)

Final score
76.69 of 100Reported as group
Quality
57.54
Promoting interoperability
51
Improvement activities
40
Cost
88.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04889TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
My Health My Resources of Tarrant County Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

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, 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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1366603565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGARS",
        "first_name": "COREY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199957501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01527358",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8539NF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199957508",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.