Justin Robert Fawell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10075 Issued in TX

Practice address

5750 W Vickery Blvd Ste 104
Fort Worth, TX 76107-7448

Phone

(817) 732-2878

Fax

(817) 732-9315

NPI assigned

Oct 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfawell1047985@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Ventura, CA
  • NPI 1679631907
  Medicare reassignment NPD (past)
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Waxahachie, TX
  • NPI 1598658015
  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Clinicas del Camino Real Inc

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1235866138
  NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Oxnard, CA
  • NPI 1427276278
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Medical Center at Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1952552291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W VICKERY BLVD STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077448",
            "telephone_number": "817-732-2878",
            "fax_number": "817-732-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W VICKERY BLVD STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077448",
            "telephone_number": "817-732-2878",
            "fax_number": "817-732-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWELL",
        "first_name": "JUSTIN",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-06",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19986",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Elizabeth Faulman, MD
• Danielle Fauss, PT, DPT
• Macy Danielle Faust
• Benjamin Favela
• Kristin Meyertholen Favela, M.D.
• Allison Fawson, MS, NCC, LPC-ASSOCIA
• Gabriel T Faz, MD
• Beverly Feaster
• Federal Bureau of Prisons
• Hayes Fejer, PA-C

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.