Maria Pham Ravanzo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04412 Issued in TX

Practice address

816 W Cannon St
Fort Worth, TX 76104-3146

Phone

(817) 321-0937

NPI assigned

Oct 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Clinical Care in RadiologyGroup PAC ID 8729429592, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• JPS Health Network Hospital, Fort Worth, TX, CCN 450039
• Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975
  Medicare reassignment Care Compare group NPD
• Clinical Care in Radiology

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1578331393
  Medicare reassignment Care Compare group
• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1730467440
  NPD

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

• Baylor All Saints Medical Center

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1669472387
  Care Compare affiliation
• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation
• Tarrant County Hospital District

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1992753222
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1366630675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVANZO",
        "first_name": "MARIA",
        "middle_name": "PHAM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Shariq Rauf, DO, MS
• Taylor Raulerson, SLP
• Diana Holton Raulston, DDS
• Mitchell Glenn Rausch, PT, DPT
• Emily Simon Rav, DO
• Shirley Raven, LCSW
• Srinivas Ravi, PHARMACIST
• Vimala Devi Ravi, APRN FNP-BC
• Aishwarya Ravivarapu
• Patricia Rawicki, M.D.

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.