MARY K POWDERLY MD
NPI 1154427227
Pediatrics in Fort Worth, TX

Active since September 16, 2006PECOS Enrolled
1263 W ROSEDALE ST STE 200, FORT WORTH, TX 76104(817) 336-4896(817) 332-2805 Get Directions Write a Review

NPPES record last updated: April 19, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 19, 2021, Apr 13, 2021, Aug 26, 2016 (3 updates tracked since 2016).

About Mary K Powderly Md NPPES

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

MARY K POWDERLY MD (NPI 1154427227) is an individual pediatrics provider in Fort Worth, Texas, licensed in Texas (L3784) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154427227
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMARY K POWDERLYCredential: MD
Location Address1263 W ROSEDALE ST STE 200Fort Worth, TX 76104-2837
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-6163 · Fax (682) 885-7347
Fax(817) 332-2805
Sole ProprietorNo
Enumeration DateSeptember 16, 2006
Last NPPES UpdateApril 19, 20213 updates tracked since enumeration
NPPES CertifiedApril 19, 2021
NPI 1154427227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in TX · L3784
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedHospitalistTaxonomy 208M00000X · License L3784 (TX)
1263 W ROSEDALE ST STE 200, Fort Worth, TX 76104

Accepted 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)

Mary K Powderly Md 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 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
$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 3

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

Nurse Practitioner (Primary Care)
1263 W ROSEDALE ST STE 200
FORT WORTH, TX 76104
Pediatrics
1263 W ROSEDALE ST STE 200
FORT WORTH, TX 76104
Pediatrics
1263 W ROSEDALE ST STE 200
FORT WORTH, TX 76104

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 Mary Powderly's NPI number?

The NPI number for Mary Powderly is 1154427227. It was assigned to this individual provider in the NPPES registry on September 16, 2006.

Where is Mary Powderly located?

Mary Powderly practices at 1263 W Rosedale St Ste 200, Fort Worth, TX 76104. The listed phone number is (817) 336-4896.

What is Mary Powderly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mary Powderly enrolled in Medicare?

Yes. Mary Powderly is registered in the Medicare PECOS enrollment system.

What insurance does Mary Powderly accept?

Health plans from Baylor Scott and White Health Plan list Mary Powderly 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 Mary Powderly was last updated on April 19, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.