Individual provider Active NPI

Karen Bonham, PA-C

  • Physician Assistant
  • Arlington, TX
National Provider Identifier
1699220095
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10610 Issued in TX
Practice address
800 W Randol Mill Rd
Arlington, TX 76012-2504
Phone
(817) 250-4906
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10610 TX Primary

Addresses

Primary practice location

800 W Randol Mill Rd
Arlington, TX 76012-2504

Mailing address

800 W Randol Mill Rd
Arlington, TX 76012-2504

Other identifiers 2

IdentifierTypeStateIssuer
363219202MedicaidTX
363219201MedicaidTX

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
I20161011001698 TX Practitioner - Physician Assistant 7416245204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

800 W Randol Mill Rd
Arlington, TX 76012-2504
Phone (817) 960-6648

Hospital & facility affiliations

  • Texas Health Arlington Memorial Hospital Hospital, Arlington, TX, CCN 450064
  • Texas Health Heart & Vascular Hospital Arlington Hospital, Arlington, TX, CCN 670071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Jul 1, 2021 Accepting new patients

Locations

811 Wright St
Arlington, TX 76012
Phone (817) 960-3500

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

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

Interoperability endpoints

  • Direct secure messaging: kbonham654261@direct.texashealth.org

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.

Hospital & facility affiliations 2

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1699220095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W RANDOL MILL RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W RANDOL MILL RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122504",
            "telephone_number": "817-250-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHAM",
        "first_name": "KAREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363219202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363219201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.