Individual provider Active NPI

Smriti Shrestha

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1457526485
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R0502 Issued in TX
Practice address
11751 Alta Vista Rd Ste 101
Fort Worth, TX 76244-6442
Phone
(817) 431-4224
Fax
(817) 623-2009
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53989 MN
Family Medicine Physician 207Q00000X A117294 CA
Family Medicine Physician 207Q00000X R0502 TX Primary

Addresses

Primary practice location

11751 Alta Vista Rd Ste 101
Fort Worth, TX 76244-6442

Mailing address

11751 Alta Vista Rd Ste 101
Fort Worth, TX 76244-6442
Phone (817) 431-4224

Other practice location 1

6601 Watauga Rd Ste 124
Watauga, TX 76148-3368
Phone (817) 702-1100

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
I20180426001939 TX Practitioner - Family Practice 6305014853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117294CAMDMarriage & Family Therapist
A117294CAMDFamily Medicine Physician
53989MNMDFamily Medicine Physician
R0502TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric & Family Physicians PA Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Apr 1, 2020 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

6601 Watauga Rd
Ste 124
Watauga, TX 76148
Phone (817) 702-6618

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.

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1457526485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11751 ALTA VISTA RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446442",
            "telephone_number": "817-431-4224",
            "fax_number": "817-623-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11751 ALTA VISTA RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446442",
            "telephone_number": "817-431-4224",
            "fax_number": "817-623-2009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6601 Watauga Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Watauga",
            "state": "TX",
            "postal_code": "761483368",
            "country_code": "US",
            "telephone_number": "817-702-1100",
            "fax_number": "817-702-6603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "SMRITI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53989",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117294",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R0502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.