Individual provider Active NPI

Ena Osmanovic

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1760210280
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1168178 Issued in TX
Practice address
1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone
(817) 335-5288
Fax
(817) 338-0927
NPI assigned
Jul 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 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 1168178 TX
Acute Care Nurse Practitioner 363LA2100X 1168178 TX Primary

Addresses

Primary practice location

1201 Fairmount Ave
Fort Worth, TX 76104-4215

Mailing address

1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone (817) 335-5288

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
I20241031004346 TX Practitioner - Nurse Practitioner 6608309497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

515 W Mayfield Rd
Suite 240
Arlington, TX 76014-2084
Phone (817) 335-5288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1168178TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pulmonary & Critical Care Consultants, PA CurrentSince Oct 1, 2024 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA PastSince Jul 28, 2024 Accepting new patients

Locations

515 W Mayfield Rd
Ste 240
Arlington, TX 76014
Phone (469) 301-1725

1201 Fairmount Ave
Fort Worth, TX 76104
Phone (817) 335-5288

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72070

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 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": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1760210280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FAIRMOUNT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044215",
            "telephone_number": "817-335-5288",
            "fax_number": "817-338-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FAIRMOUNT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044215",
            "telephone_number": "817-335-5288",
            "fax_number": "817-338-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSMANOVIC",
        "first_name": "ENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1168178",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1168178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.