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MRS. AUDREY RAQUEL NELSON PA
NPI 1003961202
Physician Assistant in Fort Worth, TX

Active since January 25, 2007PECOS EnrolledAccepts Medicare Assignment
901 HEMPHILL ST, FORT WORTH, TX 76104(817) 332-4060(817) 332-2304 Get Directions Write a Review

NPPES record last updated: June 10, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Audrey Raquel Nelson Pa NPPES

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

MRS. AUDREY RAQUEL NELSON PA (NPI 1003961202) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (PA10397) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1003961202
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. AUDREY RAQUEL NELSONCredential: PA
Location Address901 HEMPHILL STFort Worth, TX 76104-3111
Mailing AddressP.o. Box 961205Fort Worth, TX 76161-1205 · (817) 740-8400 · Fax (817) 378-3699
Phone(817) 332-4060
Fax(817) 332-2304
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJanuary 25, 2007
Last NPPES UpdateJune 10, 2016
✔ NPI 1003961202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA10397
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
901 HEMPHILL ST, Fort Worth, TX 76104
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Other Names 1

Other Name (5)Ms. Audrey Custodio Pa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Audrey Raquel Nelson Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507164183
PECOS Enrollment IDI20160414001778
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
226 services143 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
42 services42 patients
Repositioning exercises of head for treatment of dizziness, each day 95992
Repositioning exercises of the head help manage dizziness by training your brain to cope with the signals that trigger this sensation. Daily, gentle movements of the head and body can reduce symptoms and improve balance.
16 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
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 2

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

CARA JONES
Audiologist
901 HEMPHILL ST
FORT WORTH, TX 76104
Tarrant County (817) 332-4060
MR. PHILIP F ANTHONY M.D.
Otolaryngology
901 HEMPHILL ST
FORT WORTH, TX 76104
Tarrant County (817) 332-4060

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 Audrey Nelson's NPI number?

The NPI number for Audrey Nelson is 1003961202. It was assigned to this individual provider in the NPPES registry on January 25, 2007. The provider is also known as Ms. Audrey Custodio PA.

Where is Audrey Nelson located?

Audrey Nelson practices at 901 Hemphill St, Fort Worth, TX 76104. The listed phone number is (817) 332-4060.

What is Audrey Nelson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Audrey Nelson enrolled in Medicare?

Yes. Audrey Nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Audrey Nelson accept?

Health plans from Blue Cross and Blue Shield of Texas list Audrey Nelson 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 Audrey Nelson was last updated on June 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.