Individual provider Active NPI

Teressa Rasheed, P.A.-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1386748804
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02216 Issued in TX
Practice address
1217 Oakland Blvd
Fort Worth, TX 76103-1125
Phone
(817) 457-3853
Fax
(817) 457-2794
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 PA02216 TX Primary

Addresses

Primary practice location

1217 Oakland Blvd
Fort Worth, TX 76103-1125

Mailing address

1217 Oakland Blvd
Fort Worth, TX 76103-1125
Phone (817) 457-3853

Other identifiers 4

IdentifierTypeStateIssuer
211965303MedicaidTX
211965304MedicaidTX
211965301MedicaidTX
211965302MedicaidTX

Other names 1

  • Teressa Woodson Former name

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
I20060929000193 TX Practitioner - Physician Assistant 5395740179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychcare of Dallas I PLLCGroup PAC ID 2466625371, 46 clinicians

Practice addresses (Care Compare)

1241 Westridge Ave
Westridge Nursing and Rehabilitation LP
Lancaster, TX 75146-1442
Phone (972) 227-5110

4200 Shepherd LN
Balch Springs, TX 75180-3423
Phone (972) 286-0335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1386748804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 OAKLAND BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761031125",
            "telephone_number": "817-457-3853",
            "fax_number": "817-457-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 OAKLAND BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761031125",
            "telephone_number": "817-457-3853",
            "fax_number": "817-457-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASHEED",
        "first_name": "TERESSA",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211965303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211965304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211965301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211965302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESSA",
            "last_name": "WOODSON",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.