NPIMap

Individual provider Active NPI

Paul Andrew Fabela, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1700103132
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P5178 Issued in TX
Practice address
3455 Locke Ave
Fort Worth, TX 76107-5745
Phone
(817) 336-1189
NPI assigned
Apr 25, 2010
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P5178 TX Primary

Addresses

Primary practice location

3455 Locke Ave
Fort Worth, TX 76107-5745

Mailing address

4561 Heritage Trace Pkwy Ste 109
Fort Worth, TX 76244-8907
Phone (682) 200-0035

Other identifiers 3

IdentifierTypeStateIssuer
322641702OtherTXMEDICAID - MCNT - TARRANT
299305YNGSOtherTXMEDICARE - MCNT - TARRANT
3226417-01MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pfabela510778@direct.texashealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130826000054 TX Practitioner - Internal Medicine 7719120625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2010
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)

3455 Locke Ave
Suite 315
Fort Worth, TX 76107-5747
Phone (817) 336-1189

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P5178TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Jul 1, 2020 Accepting new patients
Texas Health Physicians Group Internal Medicine Past Accepting new patients
Physicians Medical Center, LLC Past Accepting new patients

Locations

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

3455 Locke Ave
Ste 315
Fort Worth, TX 76107
Phone (817) 336-1189

6020 W Parker Rd
Plano, TX 75093
Phone (972) 403-2700

Interoperability endpoints

  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
  • Direct secure messaging: pfabela510778@direct.texashealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1272153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1700103132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4561 HERITAGE TRACE PKWY STE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448907",
            "telephone_number": "682-200-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LOCKE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075745",
            "telephone_number": "817-336-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABELA",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-25",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P5178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - MCNT - TARRANT",
            "identifier": "322641702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - MCNT - TARRANT",
            "identifier": "299305YNGS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3226417-01",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfabela510778@direct.texashealth.org",
            "affiliation": "N",
            "address_1": "3455 Locke Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761075745",
            "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.