Individual provider Active NPI

Rodney D Vitovsky, PA-C

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1619912581
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA02563 Issued in TX
Practice address
800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Phone
(817) 250-4280
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA02563 TX Primary

Addresses

Primary practice location

800 5TH Ave Ste 500
Fort Worth, TX 76104-7304

Mailing address

800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Phone (817) 250-4280

Other identifiers 1

IdentifierTypeStateIssuer
8N8272OtherTXBLUE CROSS BLUE SHIELD

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
I20050303000070 TX Practitioner - Physician Assistant 8426001306 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

800 5TH Ave
Fort Worth, TX 76104-7304

8440 Walnut Hill LN
Suite 800
Dallas, TX 75231-3825
Phone (214) 345-5999

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 1, 2021 Accepting new patients
Tyler Neurosurgical Associates, P.a. Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

800 5th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 250-4280

Interoperability endpoints

  • Direct secure messaging: rvitovsky27755@direct.texashealth.org

Organizations & group practices 4

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1619912581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047304",
            "telephone_number": "817-250-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047304",
            "telephone_number": "817-250-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITOVSKY",
        "first_name": "RODNEY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA02563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N8272",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.