Individual provider Active NPI

Eva J Bailey, M.D.

  • Pain Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1669476990
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
H5299 Issued in TX
Practice address
823 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone
(817) 332-3664
Fax
(817) 882-9888
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X H5299 TX Primary

Addresses

Primary practice location

823 Pennsylvania Ave
Fort Worth, TX 76104-2224

Mailing address

PO Box 2457
Fort Worth, TX 76113-2457
Phone (817) 332-3664

Other identifiers 4

IdentifierTypeStateIssuer
079577501MedicaidTX
0040CGOtherTXBCBSTX GROUP ID
038391101MedicaidTX
82931GOtherTXBCBSTX PROVIDER ID

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
I20130918000106 TX Practitioner - Pain Management 2264416643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Eastern Virginia Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Pain Medicine Associates PAGroup PAC ID 1254328578, 3 clinicians

Practice addresses (Care Compare)

823 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 332-3664

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Pain Medicine Associates PA CurrentSince Jun 26, 2013 Accepting new patients

Locations

1401 Henderson St
Fort Worth, TX 76102
Phone (817) 924-2116

311 University Dr
Fort Worth, TX 76107
Phone (817) 207-0281

823 Pennsylvania Ave
Ft Worth, TX 76104

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Interoperability endpoints

  • Direct secure messaging: eva.bailey.1@20286.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20286/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1669476990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2457",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132457",
            "telephone_number": "817-332-3664",
            "fax_number": "817-882-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-332-3664",
            "fax_number": "817-882-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "EVA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "H5299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079577501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GROUP ID",
            "identifier": "0040CG",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038391101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PROVIDER ID",
            "identifier": "82931G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.