Jeff L Pugach, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

L3077 Issued in TX

Practice address

750 8TH Ave FL 6
Fort Worth, TX 76104-2515

Phone

(682) 303-0376

Fax

(682) 303-0377

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Urology

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cook Childrens Physician NetworkGroup PAC ID 7719884584, 307 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpugach16337@cookchildrens.direct-ci.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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment Care Compare group NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Urology Associates of North Texas LLP

  • Urology Physician
  • Weatherford, TX
  • NPI 1407849961
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1871589978",
    "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": "750 8TH AVE FL 6",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042515",
            "telephone_number": "682-303-0376",
            "fax_number": "682-303-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGACH",
        "first_name": "JEFF",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "TX",
            "license": "L3077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpugach16337@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "750 8th Ave Fl 6",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Puckett, SLP
• Bidya Pudasaini, AGACNP-BC
• Selena Puente
• Anna Eligia Puentez, RN, CPNP-PC
• Matthew Reed Pueringer, DO
• Alyssa Renelle Pugh, CRNA
• Billie Raymond Pugh Jr., MD
• Srinivas Reddy Puli, M.D
• Mia Elena Pulido
• Rhizhene Pullen-Parmes

• Pediatric Urology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.