Individual provider Active NPI

Charles A Kwaw, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1376574541
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K6072 Issued in TX
Practice address
5701 Bryant Irvin Rd Ste 201
Fort Worth, TX 76132-4026
Phone
(817) 263-2500
Fax
(817) 346-4006
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K6072 TX Primary

Addresses

Primary practice location

5701 Bryant Irvin Rd Ste 201
Fort Worth, TX 76132-4026

Mailing address

5701 Bryant Irvin Rd Ste 201
Fort Worth, TX 76132-4026
Phone (817) 263-2500

Other identifiers 3

IdentifierTypeStateIssuer
138021414MedicaidTX
138021416MedicaidTX
138021415MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505001612 TX Practitioner - Internal Medicine 0648268946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

5701 Bryant Irvin Rd
Suite 201
Fort Worth, TX 76132-4026
Phone (817) 263-2500

Hospital & facility affiliations

  • DFW Home Health Home health agency, Fort Worth, TX, CCN 457575
  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Jan 1, 2011 Accepting new patients
Texas Health Physicians Group Internal Medicine Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

5701 Bryant Irvin Rd
Ste 201
Fort Worth, TX 76132
Phone (817) 263-2500

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: ckwaw5287@direct.texashealth.org

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 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1376574541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324026",
            "telephone_number": "817-263-2500",
            "fax_number": "817-346-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324026",
            "telephone_number": "817-263-2500",
            "fax_number": "817-346-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAW",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138021414",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138021416",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138021415",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.