Individual provider Active NPI

Dustin Ryan Tolar, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1760148092
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1058628 Issued in TX
Practice address
1902 Windsor PL Ste 102
Fort Worth, TX 76110-1866
Phone
(682) 207-1700
Fax
(682) 250-5246
NPI assigned
Nov 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1058628 TX
Acute Care Nurse Practitioner 363LA2100X 1058628 TX Primary

Addresses

Primary practice location

1902 Windsor PL Ste 102
Fort Worth, TX 76110-1866

Mailing address

1902 Windsor PL Ste 102
Fort Worth, TX 76110-1866
Phone (682) 207-1700

Other identifiers 1

IdentifierTypeStateIssuer
1760148092MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dtolar53448@direct.acumenmd.com

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
I20211221002406 TX Practitioner - Nurse Practitioner 1658762976 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

11801 S Fwy
I 35W
Burleson, TX 76028-7021
Phone (817) 293-9110

1500 S Main St
John Peter Smith Hospital
Fort Worth, TX 76104-4917
Phone (817) 702-3431

18951 N Memorial Dr
Humble, TX 77338-4217
Phone (281) 319-8409

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1058628TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fortworth Renal Group PA CurrentSince May 15, 2023 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Dec 16, 2021 Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637

1902 Windsor Pl
Ste 102
Fort Worth, TX 76110

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

Organizations & group practices 4

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 3

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": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1760148092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 WINDSOR PL STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101866",
            "telephone_number": "682-207-1700",
            "fax_number": "682-250-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 WINDSOR PL STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101866",
            "telephone_number": "682-207-1700",
            "fax_number": "682-250-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLAR",
        "first_name": "DUSTIN",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1058628",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1058628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760148092",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dtolar53448@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "1902 Windsor Pl Ste 102",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761101866",
            "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.