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MRS. AMY MICHELLE MEDALIE NP
NPI 1003045204
Nurse Practitioner - Pediatrics in Fort Worth, TX

Active since July 08, 2009PECOS Enrolled
4405 RIVER OAKS BLVD, FORT WORTH, TX 76114(817) 624-1770(817) 625-1287 Get Directions Write a Review

NPPES record last updated: April 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Amy Michelle Medalie Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. AMY MICHELLE MEDALIE NP (NPI 1003045204) is an individual pediatrics provider in Fort Worth, Texas, licensed in Colorado (6037) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lakewood.

NPPES Registry Identity

NPI1003045204
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMRS. AMY MICHELLE MEDALIECredential: NP
Location Address4405 RIVER OAKS BLVDFort Worth, TX 76114-2326
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855
Phone(817) 624-1770
Fax(817) 625-1287
Sole ProprietorNo
Enumeration DateJuly 8, 2009
Last NPPES UpdateApril 7, 2021
NPPES CertifiedApril 7, 2021
✔ NPI 1003045204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CO · 6037
4405 RIVER OAKS BLVD, Fort Worth, TX 76114
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Other Names 1

Former Name (1)Amy Michelle Medalie Rn

Secondary Practice Location 1

Location 1255 Union Blvd Ste 120Lakewood, CO 80228-1833 · Phone (303) 936-7415

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Amy Michelle Medalie Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LIA S RAMOS-GILLIN DO
Pediatrics
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
MOLLY MARIE DENNY
Pediatrics
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
MRS. CHRISTINA LEIGH MCGUYER CPNP-AC
Nurse Practitioner (Acute Care)
4405 RIVER OAKS BLVD
FT WORTH, TX 76114
Tarrant County (817) 624-1770
DR. SHARHONDA MARIE ANSLEY M.D.
Pediatrics
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
MONICA STERLING SLP
Speech-Language Pathologist
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
ROBIN J HENSON CPNP-PC
Nurse Practitioner (Pediatrics)
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
ELIZABETH NICHOLE BELLOWS FNP-C
Nurse Practitioner (Family)
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770
VICTORIA DAO MD
Pediatrics
4405 RIVER OAKS BLVD
FORT WORTH, TX 76114
Tarrant County (817) 624-1770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Medalie's NPI number?

The NPI number for Amy Medalie is 1003045204. It was assigned to this individual provider in the NPPES registry on July 8, 2009. The provider is also known as Amy Michelle Medalie Rn.

Where is Amy Medalie located?

Amy Medalie practices at 4405 River Oaks Blvd, Fort Worth, TX 76114. The listed phone number is (817) 624-1770.

What is Amy Medalie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Amy Medalie enrolled in Medicare?

Yes. Amy Medalie is registered in the Medicare PECOS enrollment system.

What insurance does Amy Medalie accept?

Health plans from Imperial Insurance Companies, Inc. list Amy Medalie as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amy Medalie was last updated on April 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.