NPIMap

Organization Active NPI

Access 360 Care Inc

Doing business as NTX 360 Care

  • Internal Medicine Physician
  • Arlington, TX
National Provider Identifier
1962156802
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ACCESS 360 CARE INC
Doing business as
NTX 360 Care
Practice address
4381 W Green Oaks Blvd Ste 103
Arlington, TX 76016-4495
Phone
(817) 200-4469
NPI assigned
Feb 9, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Todd L Petelski
Title
Owner
Phone
(817) 200-4469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4381 W Green Oaks Blvd Ste 103
Arlington, TX 76016-4495

Mailing address

PO Box 150569
Arlington, TX 76015-6569
Phone (682) 302-0306

Other names 1

  • NTX 360 Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220225000348 TX Part B Supplier - Clinic/Group Practice 6901290543 Receives reassigned benefits from 20 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Locations

4381 W Green Oaks Blvd
#10
Arlington, TX 76016
Phone (682) 302-0306

4381 W Green Oaks Blvd
Ste 103
Arlington, TX 76016
Phone (682) 302-0306

4681 SW GRN Oaks Blvd Ste 103
Arlington, TX 76017

2910 W Park Row Dr
Pantego, TX 76013

2910 W Park Row Dr
Ste 150
Pantego, TX 76013

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1962156802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150569",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760156569",
            "telephone_number": "682-302-0306",
            "fax_number": "682-334-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 W GREEN OAKS BLVD STE 103",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760164495",
            "telephone_number": "817-200-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS 360 CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "PETELSKI",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-200-4469"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NTX 360 Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NTX 360 Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.