Individual provider Active NPI

Ashli Corazon Bartolo, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1396435350
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14860 Montfort Dr # 140
Dallas, TX 75254-6718
Phone
(972) 201-3552
NPI assigned
May 11, 2023
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Family Medicine Physician 207Q00000X PA18663 TX

Addresses

Primary practice location

14860 Montfort Dr # 140
Dallas, TX 75254-6718

Mailing address

14860 Montfort Dr # 140
Dallas, TX 75254-6718

Other practice location 1

8420 Abrams Rd Ste 208
Dallas, TX 75243-7582
Phone (214) 341-5630

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
I20260112002428 TX Practitioner - Physician Assistant 8426549965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14850 Montfort Dr
Suite 181
Dallas, TX 75254-1423

14860 Montfort Dr
Suite 140
Dallas, TX 75254-6700

14860 Montfort Dr
Suite 140
Dallas, TX 75254-6718

3219 Pamplona
Grand Prairie, TX 75054-6858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18663TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kokoro Body Therapies, PLLC CurrentSince Nov 1, 2025 Accepting new patients
Kokoro Health & Wellness Inc. CurrentSince Dec 1, 2025 Accepting new patients

Locations

14850 Montfort Dr
Ste 181
Dallas, TX 75254
Phone (214) 550-1469

14860 Montfort Dr
Ste 140
Dallas, TX 75254
Phone (214) 550-1469

8420 Abrams Rd
Ste 208
Dallas, TX 75243
Phone (214) 341-5630

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGCJBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HGCJBD/Endpoint/HGCJBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1396435350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14860 MONTFORT DR # 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752546718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14860 MONTFORT DR # 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752546718",
            "telephone_number": "972-201-3552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8420 Abrams Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752437582",
            "country_code": "US",
            "telephone_number": "214-341-5630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTOLO",
        "first_name": "ASHLI",
        "middle_name": "CORAZON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "PA18663",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.