Individual provider Active NPI

Shashwata Chakrabarty, DO

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1912469602
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T9655 Issued in TX
Practice address
1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-3104
Phone
(817) 250-4906
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T9655 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-3104

Mailing address

1013 Manchester Dr
Mansfield, TX 76063-8403
Phone (817) 233-4383

Other practice location 1

44 Blaine Ave
Bedford, OH 44146-2709
Phone (440) 735-3900

Other practice location 2

27100 Chardon Rd
Richmond Heights, OH 44143-1116
Phone (440) 585-6500

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
I20230127000696 TX Practitioner - Internal Medicine 6002140944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
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)

1300 W Terrell Ave
Suite K230
Fort Worth, TX 76104-3104
Phone (817) 250-7240

Hospital & facility affiliations

  • Community Healthcare of Texas Hospice, Fort Worth, TX, CCN 451501
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Virtual Care Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Feb 1, 2023 Accepting new patients
Texas Health Physicians Group CurrentSince Feb 1, 2023 Accepting new patients
Texas Health Virtual Care CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past 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

8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001

1300 W Terrell Ave
Ste K230
Fort Worth, TX 76104
Phone (817) 250-7240

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

Interoperability endpoints

  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
  • Direct secure messaging: schakrabarty2294706@direct.texashealth.org

Organizations & group practices 7

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 2

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1912469602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 MANCHESTER DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638403",
            "telephone_number": "817-233-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE K230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043104",
            "telephone_number": "817-250-4906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 Blaine Ave",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "OH",
            "postal_code": "441462709",
            "country_code": "US",
            "telephone_number": "440-735-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27100 Chardon Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "OH",
            "postal_code": "441431116",
            "country_code": "US",
            "telephone_number": "440-585-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAKRABARTY",
        "first_name": "SHASHWATA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T9655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.