Individual provider Active NPI

Sarah Elizabeth Shaffer, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1780351908
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14732 Issued in TX
Practice address
1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone
(817) 335-5288
Fax
(817) 338-0927
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14732 TX
Physician Assistant 363A00000X PA14732 TX Primary

Addresses

Primary practice location

1201 Fairmount Ave
Fort Worth, TX 76104-4215

Mailing address

601 Omega Dr Ste 208
Arlington, TX 76014-2075
Phone (817) 465-5881

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
I20210922001774 TX Practitioner - Physician Assistant 3072910736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14732TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Pulmonary Associates LLC CurrentSince Nov 1, 2022 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA PastSince Aug 29, 2021 Accepting new patients

Locations

601 Omega Dr
Ste 208
Arlington, TX 76014
Phone (817) 465-5881

Interoperability endpoints

  • Direct secure messaging: sshaffer1821476@direct.texashealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHJCD

Organizations & group practices 3

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 4

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1780351908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OMEGA DR STE 208",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142075",
            "telephone_number": "817-465-5881",
            "fax_number": "817-394-6294"
        },
        {
            "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": "SHAFFER",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA14732",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.