Individual provider Active NPI

Rachel Gambulos Hamilton, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1841637030
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q6630 Issued in TX
Practice address
1108 S Henderson St
Fort Worth, TX 76104-4430
Phone
(817) 335-3255
Fax
(817) 338-9563
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP1-0045911 TX
Pediatrics Physician 208000000X Q6630 TX Primary

Addresses

Primary practice location

1108 S Henderson St
Fort Worth, TX 76104-4430

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Other names 1

  • Rachel Marie Gambulos Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rhamilton14224@CookChildrens.direct-ci.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160729000629 TX Practitioner - Pediatric Medicine 5597058438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP1-0045911TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics Current Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Cook Children's Medical Center Past Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1108 S Henderson St
Ft Worth, TX 76104
Phone (817) 335-3255

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

Interoperability endpoints

  • Direct secure messaging: rhamilton14224@cookchildrens.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1841637030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044430",
            "telephone_number": "817-335-3255",
            "fax_number": "817-338-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "RACHEL",
        "middle_name": "GAMBULOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0045911",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q6630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhamilton14224@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1108 S Henderson St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "GAMBULOS",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.