Individual provider Active NPI

Hector Grajeda Acosta, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1659389757
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M2229 Issued in TX
Practice address
4405 River Oaks Blvd
Fort Worth, TX 76114-2326
Phone
(817) 624-1770
Fax
(817) 625-1287
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M2229 TX Primary

Addresses

Primary practice location

4405 River Oaks Blvd
Fort Worth, TX 76114-2326

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hgrajedaacosta14063@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070222000480 TX Practitioner - Pediatric Medicine 3173625118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M2229TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Oct 6, 2011 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Oct 6, 2011 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

4405 River Oaks Blvd
Ft Worth, TX 76114
Phone (817) 624-1770

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Interoperability endpoints

  • Direct secure messaging: hgrajedaacosta14063@cookchildrens.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1659389757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 RIVER OAKS BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761142326",
            "telephone_number": "817-624-1770",
            "fax_number": "817-625-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJEDA ACOSTA",
        "first_name": "HECTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M2229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hgrajedaacosta14063@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4405 River Oaks Blvd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761142326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.