Active NPI
Johnson Diaz Dellosa, M.D.
- Family Medicine Physician
- Alvarado, TX
National Provider Identifier
1386696136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M3516
- Practice address
- 515 East Highway 67
Alvarado, TX 76009 - Phone
- (817) 783-2318
- Fax
- (817) 783-2319
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M3516 | TX | Primary |
Addresses
Primary practice location
515 East Highway 67
Alvarado, TX 76009
Mailing address
PO Box 6278
Fort Worth, TX 76115-0278
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8AS312 | Other | TX | BCBS |
| 1386696136 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071218000171 | TX | Practitioner - Family Practice | 4880784529 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Huguley Medical Associates, Inc
Practice addresses (Care Compare)
515 E Hwy 67
Huguley Medical Associates Inc Johnson de
Alvarado, TX 76009
Phone (817) 783-2318
Hospital & facility affiliations
- Texas Health Huguley Hospital Fort Worth South
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.59 of 100
- Quality
- 74.14
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.17
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Huguley Medical Associates | Current | Accepting new patients | |
| Family Medical Associates,LLC | Family Medicine | Past | Accepting new patients |
| Heartplace, PLLC | Past | Accepting new patients |
Locations
515 E Highway 67
Alvarado, TX 76009
Phone (817) 783-2318
11797 South Fwy
Ste 242
Burleson, TX 76028
Phone (817) 568-1981
11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738
Interoperability endpoints
- jdellosa660561@adventhealth.direct-ci.com
- https://api.platform.athenahealth.com/14273/brand/6/csg/1/fhir/r4
Organizations & group practices 3
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.
-
- Cardiac Rehabilitation Registered Nurse
- Arlington, TX
- NPI 1033943394
-
- Family Medicine Physician
- Westminster, MD
- NPI 1922014349
Family Medicine
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": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1386696136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6278",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761150278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 EAST HIGHWAY 67",
"city": "ALVARADO",
"state": "TX",
"postal_code": "76009",
"telephone_number": "817-783-2318",
"fax_number": "817-783-2319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLOSA",
"first_name": "JOHNSON",
"middle_name": "DIAZ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "M3516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8AS312",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1386696136",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alvarado, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.