Individual provider Active NPI

Alexandria Tristine Pitts

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1538686902
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19014 Issued in TX
Practice address
3500 Camp Bowie Blvd
Fort Worth, TX 76107
Phone
(817) 735-2000
NPI assigned
Aug 27, 2017
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19014 TX Primary

Addresses

Primary practice location

3500 Camp Bowie Blvd
Fort Worth, TX 76107

Mailing address

2910 E 17TH St Unit 503
Austin, TX 78702-1463
Phone (925) 683-9853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251017002075 NY Practitioner - Physician Assistant 3274020623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Park Ave
FL 11
New York, NY 10016-5803

700 Hicksville Rd
Bethpage, NY 11714-3471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033734NYMDPhysical Therapist
PA19014TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2025 Accepting new patients
New York University CurrentSince Oct 1, 2025 Accepting new patients

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": "1503792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1538686902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 E 17TH ST UNIT 503",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787021463",
            "telephone_number": "925-683-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76107",
            "telephone_number": "817-735-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "ALEXANDRIA",
        "middle_name": "TRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-27",
        "last_updated": "2025-05-08",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.