Individual provider Active NPI

Colleen P Piechocki, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1619624541
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1053778 Issued in TX
Practice address
1650 W Rosedale St Ste 220
Fort Worth, TX 76104-7432
Phone
(682) 312-4038
Fax
(682) 312-4045
NPI assigned
Mar 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1053778 TX Primary

Addresses

Primary practice location

1650 W Rosedale St Ste 220
Fort Worth, TX 76104-7432

Mailing address

1650 W Rosedale St Ste 220
Fort Worth, TX 76104-7432
Phone (682) 312-4038

Other practice location 1

200 N Mesquite St Ste 115
Arlington, TX 76011-7560
Phone (817) 200-2530

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
I20220323000808 TX Practitioner - Nurse Practitioner 2860887106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Infusions LLCGroup PAC ID 6608054044, 102 clinicians

Practice addresses (Care Compare)

200 N Mesquite St
Suite 115
Arlington, TX 76011-7560
Phone (817) 200-2530

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1053778TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Infusions, LLC CurrentSince Apr 4, 2022 Accepting new patients
Innovative Infusions, LLC CurrentSince Apr 4, 2022 Accepting new patients

Locations

200 N Mesquite St
Ste 115
Arlington, TX 76011
Phone (817) 200-2530

720 W 34th St
Ste 104
Austin, TX 78705
Phone (512) 261-4800

113 E State Highway 121
Ste 110
Coppell, TX 75019
Phone (469) 946-6577

11317 N Central Expy
Ste 100
Dallas, TX 75243
Phone (972) 408-2777

1650 W Rosedale St
Ste 220
Fort Worth, TX 76104
Phone (682) 312-4038

3033 W President George Bush Hwy
Ste 200
Plano, TX 75075

4709 W Parker Rd
Ste 500
Plano, TX 75093
Phone (469) 974-0565

7560 Glenview Dr
Ste 110
Richland Hills, TX 76180
Phone (817) 284-2700

1922 Dry Creek Way
Ste 134
San Antonio, TX 78259
Phone (210) 485-3700

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.

NPI Registry JSON

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1619624541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W ROSEDALE ST STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047432",
            "telephone_number": "682-312-4038",
            "fax_number": "682-312-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W ROSEDALE ST STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047432",
            "telephone_number": "682-312-4038",
            "fax_number": "682-312-4045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 N Mesquite St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760117560",
            "country_code": "US",
            "telephone_number": "817-200-2530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIECHOCKI",
        "first_name": "COLLEEN",
        "middle_name": "P",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1053778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.