Individual provider Active NPI

Brooke Stovall, PA

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1811361694
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10223 Issued in TX
Practice address
800 5TH Ave Ste 300a
Fort Worth, TX 76104-7300
Phone
(817) 250-4265
NPI assigned
Nov 17, 2015
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10223 TX Primary

Addresses

Primary practice location

800 5TH Ave Ste 300a
Fort Worth, TX 76104-7300

Mailing address

800 5TH Ave Ste 300a
Fort Worth, TX 76104-7300
Phone (817) 250-4265

Other names 1

  • Brooke Burge Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bstovall1109962@Direct.TexasHealth.org

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
I20151215001718 TX Practitioner - Physician Assistant 3870894900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

800 5TH Ave
Suite 300
Fort Worth, TX 76104-7303
Phone (817) 250-5690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10223TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Dec 30, 2015 Accepting new patients
Texas Health Physicians Group CurrentSince Dec 30, 2015 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

800 5th Ave
Ste 300A
Fort Worth, TX 76104
Phone (817) 250-4265

800 5th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 334-1400

800 5th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 250-4280

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: bstovall1109962@direct.texashealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1811361694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 300A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047300",
            "telephone_number": "817-250-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 300A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047300",
            "telephone_number": "817-250-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "BROOKE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA10223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bstovall1109962@Direct.TexasHealth.org",
            "affiliation": "N",
            "address_1": "800 5th Ave Ste 300A",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761047300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "BURGE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.