Individual provider Active NPI

Lovely Philipose, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1386884286
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S0536 Issued in TX
Practice address
1950 Ephriham Ave
Fort Worth, TX 76164-6670
Phone
(817) 813-7075
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S0536 TX Primary
Family Medicine Physician 207Q00000X 35.094372 OH

Addresses

Primary practice location

1950 Ephriham Ave
Fort Worth, TX 76164-6670

Mailing address

PO Box 746079
Atlanta, GA 30374-6079
Phone (773) 352-1515

Other practice location 1

720 S Main St
Keller, TX 76248-4936
Phone (817) 431-2800

Other identifiers 1

IdentifierTypeStateIssuer
3005670MedicaidOH

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
I20210720002611 TX Practitioner - Family Practice 5799829206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

779 Grapevine Hwy
Hurst, TX 76054-2805
Phone (817) 428-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.094372OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Texas, PLLC Family Medicine CurrentSince Oct 27, 2025 Accepting new patients
Integrative Emergency Services Physician Group PA CurrentSince Mar 1, 2022 Accepting new patients

Locations

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

1950 Ephriham Ave
Fort Worth, TX 76164
Phone (817) 813-7075

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

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.

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1386884286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746079",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746079",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 EPHRIHAM AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761646670",
            "telephone_number": "817-813-7075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 S Main St",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762484936",
            "country_code": "US",
            "telephone_number": "817-431-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIPOSE",
        "first_name": "LOVELY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S0536",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.094372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3005670",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.