Individual provider Active NPI

Angelene Marcell Stewart, D.O.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1710923149
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K1077 Issued in TX
Practice address
7120 McCart Ave
Fort Worth, TX 76133-4200
Phone
(817) 294-5624
Fax
(817) 294-4711
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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 K1077 TX Primary

Addresses

Primary practice location

7120 McCart Ave
Fort Worth, TX 76133-4200

Mailing address

7120 McCart Ave
Fort Worth, TX 76133-4200
Phone (817) 294-5624

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
I20050114000247 TX Practitioner - Internal Medicine 3870542087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Ronald a Stewart DO PAGroup PAC ID 1153496559, 2 clinicians

Practice addresses (Care Compare)

7120 McCart Ave
Fort Worth, TX 76133-7298
Phone (817) 294-5624

Hospital & facility affiliations

  • DFW Home Health Home health agency, Fort Worth, TX, CCN 457575
  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K1077TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald a Stewart, D.O., P.a. Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Ralph a Brooks, M.D. LLC Past Accepting new patients

Locations

6263 McCart Ave
Ste 100
Ft Worth, TX 76133
Phone (817) 294-5624

7120 McCart Ave
Ft Worth, TX 76133
Phone (817) 294-5624

Interoperability endpoints

  • Direct secure messaging: angelene.stewart@mmainc.eclinicaldirectplus.com

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1710923149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 MCCART AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761334200",
            "telephone_number": "817-294-5624",
            "fax_number": "817-294-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 MCCART AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761334200",
            "telephone_number": "817-294-5624",
            "fax_number": "817-294-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ANGELENE",
        "middle_name": "MARCELL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K1077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.