Individual provider Active NPI

Manjot Kaur Gill, P.A.

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1386924801
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA12111 Issued in TX
Practice address
1325 Pennsylvania Ave Ste 690
Fort Worth, TX 76104-2133
Phone
(817) 761-7740
NPI assigned
Aug 29, 2011
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 015024 NY
Surgical Physician Assistant 363AS0400X PA12111 TX Primary

Addresses

Primary practice location

1325 Pennsylvania Ave Ste 690
Fort Worth, TX 76104-2133

Mailing address

462 1St Ave
New York, NY 10016-9196

Other practice location 1

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-2300

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
I20230403000606 TX Practitioner - Physician Assistant 7012175615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

800 5TH Ave
Fort Worth, TX 76104-7305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015024NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients

Locations

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

1325 Pennsylvania Ave
Ste 690
Fort Worth, TX 76104
Phone (817) 761-7740

800 5th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 702-9100

Interoperability endpoints

  • Direct secure messaging: mgill2344853@direct.texashealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1386924801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 690",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042133",
            "telephone_number": "817-761-7740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "MANJOT",
        "middle_name": "KAUR",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "015024",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA12111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.