Individual provider Active NPI

Stefanie Meyer Reisch, PA-C

  • Urology Physician
  • Fort Worth, TX
National Provider Identifier
1740750397
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
PA12527 Issued in TX
Practice address
6801 Oakmont Blvd Ste 102
Fort Worth, TX 76132-3903
Phone
(866) 376-8768
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Urology Physician 208800000X PA12527 TX Primary

Addresses

Primary practice location

6801 Oakmont Blvd Ste 102
Fort Worth, TX 76132-3903

Mailing address

5001 S Cooper St Ste 201
Arlington, TX 76017-5993

Other identifiers 1

IdentifierTypeStateIssuer
1114114279MedicaidTX

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
I20201119001593 TX Practitioner - Physician Assistant 1658782883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1701 Fountainview Dr
Suite 120
Mansfield, TX 76063-5091
Phone (866) 367-8768

3301 Matlock Rd
Arlington, TX 76015-2908
Phone (682) 509-6200

5001 S Cooper St
Suite 201
Arlington, TX 76017-5993

5005 S Cooper St
Suite 250
Arlington, TX 76017-5996
Phone (866) 367-8768

6800 N Macarthur Blvd
Medical City at Las Colinas
Irving, TX 75039-2422
Phone (972) 969-2260

6801 Oakmont Blvd
Suite 102
Fort Worth, TX 76132-3903
Phone (866) 367-8768

7701 Las Colinas RDG
Suite 460
Irving, TX 75063-8081
Phone (866) 367-8768

801 W Interstate 20
Arlington, TX 76017-5851

945 Hilltop Dr
Suite 100
Weatherford, TX 76086-5892
Phone (866) 367-8768

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Partners of North Texas, PLLC Urology PastSince Feb 2, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1740750397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 S COOPER ST STE 201",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 OAKMONT BLVD STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323903",
            "telephone_number": "866-376-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISCH",
        "first_name": "STEFANIE",
        "middle_name": "MEYER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "PA12527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114114279",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.