Individual provider Active NPI

Ancy Kurian Chempola, PA-C

  • Physician Assistant
  • Grapevine, TX
National Provider Identifier
1629549498
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19207 Issued in TX
Practice address
3801 William D Tate Ave Ste 840
Grapevine, TX 76051-8759
Phone
(817) 310-3772
Fax
(817) 310-3950
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022898 NY
Physician Assistant 363A00000X PA19207 TX Primary

Addresses

Primary practice location

3801 William D Tate Ave Ste 840
Grapevine, TX 76051-8759

Mailing address

2040 E State Highway 121 Apt 5014
Ancychempola@Texashealth.Org
Lewisville, TX 75056
Phone (646) 761-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190729000867 NY Practitioner - Physician Assistant 8325374358 Reassigns benefits to 1 organization
I20250703001983 TX Practitioner - Physician Assistant 8325374358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
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)

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

3801 William D Tate Ave
Suite 840
Grapevine, TX 76051-8759
Phone (817) 310-3772

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022898NYMDPharmacist
PA19207TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

3801 William D Tate Ave
Ste 840
Grapevine, TX 76051
Phone (817) 310-3772

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: achempola2658722@direct.texashealth.org

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 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": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1629549498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 E STATE HIGHWAY 121 APT 5014",
            "address_2": "ANCYCHEMPOLA@TEXASHEALTH.ORG",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75056",
            "telephone_number": "646-761-4704",
            "fax_number": "817-310-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 840",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518759",
            "telephone_number": "817-310-3772",
            "fax_number": "817-310-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEMPOLA",
        "first_name": "ANCY",
        "middle_name": "KURIAN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022898",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.