Fort Worth Primary Care, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M8951 Issued in TX

Legal business name

FORT WORTH PRIMARY CARE, PLLC

Practice address

800 8TH Ave Ste 626
Fort Worth, TX 76104-2605

Phone

(817) 243-7995

Fax

(844) 573-3209

NPI assigned

Feb 27, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Morvarid Rezaie, DONPI 1164692026

Title

Physician

Phone

(817) 243-7995

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Morvarid Rezaie, D.O.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Fort Worth, TX
  • NPI 1164692026
  Medicare reassignment Authorized official
• Mrunmayee Barve, M.D

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1487889705
  Medicare reassignment
• Christine Marie Milson

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1346802071
  Medicare reassignment
• Stuart Charles Pickell, MD

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1740261114
  Medicare reassignment

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594684800000",
    "number": "1417458068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 626",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042605",
            "telephone_number": "817-243-7995",
            "fax_number": "817-717-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 626",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042605",
            "telephone_number": "817-243-7995",
            "fax_number": "844-573-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A",
        "authorized_official_last_name": "REZAIE",
        "authorized_official_first_name": "MORVARID",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-243-7995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M8951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1765463",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164692026",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Fort Worth Recovery LLC
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• Internal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.