Individual provider Active NPI

Drew Ray Thompson, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1598052904
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TEMPORARY PENDING Issued in TX
Practice address
1651 W. Rosedale, Suite 200
Fort Worth, TX 76104-7437
Phone
(817) 335-4316
Fax
(817) 332-4465
NPI assigned
Jul 6, 2011
Last updated
Jan 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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 TEMPORARY PENDING TX Primary

Addresses

Primary practice location

1651 W. Rosedale, Suite 200
Fort Worth, TX 76104-7437

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 2

IdentifierTypeStateIssuer
285932401MedicaidTX
P00975532OtherTXRAILROAD MEDICARE

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
I20110926000532 TX Practitioner - Physician Assistant 6204007172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

1651 W Rosedale
Fort Worth, TX 76104-7437

1651 W Rosedale St
Fort Worth, TX 76104-7437

6700 Buenos Aires Dr
N Richland Hills, TX 76180-6566
Phone (817) 281-8245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEMPORARY PENDINGTXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. CurrentSince Aug 2, 2011 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Aug 2, 2011 Accepting new patients

Locations

1651 W Rosedale St
Ste 200
Ft Worth, TX 76104
Phone (817) 335-4316

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: drew.thompson.p1@direct.thc.nextgenshare.com
  • Direct secure messaging: dthompson@direct.uspi.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1598052904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-332-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 W. ROSEDALE, SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047437",
            "telephone_number": "817-335-4316",
            "fax_number": "817-332-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DREW",
        "middle_name": "RAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "TEMPORARY PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285932401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00975532",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.