Organization Active NPI

Munazza S. Sethi M.D, P.a

  • Geriatric Medicine (Internal Medicine) Physician
  • Fort Worth, TX
National Provider Identifier
1578879409
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
N6648 Issued in TX
Legal business name
MUNAZZA S. SETHI M.D, P.A
Practice address
1001 College Ave
Suite a
Fort Worth, TX 76104-3000
Phone
(817) 336-6000
Fax
(817) 336-2072
NPI assigned
Aug 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Authorized official

Name
Amanda G Ortega
Title
Office Manager
Phone
(817) 336-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X N6648 TX Primary

Addresses

Primary practice location

1001 College Ave
Suite a
Fort Worth, TX 76104-3000

Mailing address

1001 College Ave
Suite a
Fort Worth, TX 76104-3000
Phone (817) 336-6000

Other identifiers 1

IdentifierTypeStateIssuer
0764613MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110114000657 TX Part B Supplier - Clinic/Group Practice 2769671171 Receives reassigned benefits from 1 practitioner
Practice locations: Southlake, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1578879409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE AVE",
            "address_2": "SUITE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043000",
            "telephone_number": "817-336-6000",
            "fax_number": "817-336-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE AVE",
            "address_2": "SUITE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043000",
            "telephone_number": "817-336-6000",
            "fax_number": "817-336-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNAZZA S. SETHI M.D, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-336-6000"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "N6648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0764613",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.