Shadia Osakwe

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12890 Issued in TX

Practice address

855 Montgomery Street,
Pediatric Clinic
Fort Worth, TX 76107

Phone

(817) 735-0349

Fax

(817) 735-2653

NPI assigned

Jul 11, 2019

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

Other names 1

• Shadia Eissa Former name

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

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shadia.eissa.p1@direct.unthsc.nextgenshare.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.

• University of North Texas Health Science Center at Fort Worth

  • Neuromusculoskeletal Medicine & OMM Physician
  • Fort Worth, TX
  • NPI 1376645564
  Medicare reassignment
• University of North Texas Health Science Center at Fort Worth

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1417054024

  Physician Assistant

  NPD
• University of North Texas Health Science Center at Fort Worth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1639843790
  NPD

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1770135576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY STREET,",
            "address_2": "PEDIATRIC CLINIC",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76107",
            "telephone_number": "817-735-0349",
            "fax_number": "817-735-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY STREET,",
            "address_2": "PEDIATRIC CLINIC",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76107",
            "telephone_number": "817-735-0349",
            "fax_number": "817-735-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSAKWE",
        "first_name": "SHADIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHADIA",
            "last_name": "EISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Marie Ortiz, RD
• Tiwanna Ortiz, CERTIFIED HAIR LOSS
• Joel Ortlip, DDS
• Kwaku A Osafo-Mensah, MD
• Obiyaa Kyiraka Akua Osafo-Mensah
• Millicent Dorcas Osamba, APRN, FNP-C
• Eugene R Osborn, D.O.
• Dorothy L. Osborne, APRN, MSN, FNP-C
• Nathalia Osby
• Kaci L Osenga, MD

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.