Sofia Poonawala-Manjee, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

752444 Issued in TX

Practice address

2716 Tibbets Dr
Bedford, TX 76022-6915

Phone

(817) 571-6644

Fax

(817) 685-7951

NPI assigned

Mar 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spoonawalamanjee16278@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1710349451",
    "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": "2716 TIBBETS DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226915",
            "telephone_number": "817-571-6644",
            "fax_number": "817-685-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POONAWALA-MANJEE",
        "first_name": "SOFIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "752444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spoonawalamanjee16278@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "2727 E Southlake Blvd",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760926613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spoonawalamanjee16278@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "2716 Tibbets Dr",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760226915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristi Michelle Plunk, PT, DPT, WCS, CLT
• James D. Poettcker, M.D.
• Ronda Diane Polansky, M.S. CCC-SLP
• James Richard Polson, D.D.S.
• Sarah Anne Poole
• Tony J Porrata, LSA
• Lindsay Portz, PA-C
• Eugene Posnock, M.D.
• Post Acute Care Specialists LLC
• Ted Blake Powell, M.D.

• Family Nurse Practitioner in Bedford, TX
• Providers in Bedford, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.