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PAULINA PURNAMA PA-C
NPI 1275724981
Physician Assistant - Surgical in Fort Worth, TX

Active since August 07, 2007PECOS EnrolledAccepts Medicare Assignment
800 12TH AVE STE 200, FORT WORTH, TX 76104(214) 631-9881(469) 482-2526 Get Directions Write a Review

NPPES record last updated: May 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Aug 29, 2017, Nov 23, 2016 (3 updates tracked since 2016).

About Paulina Purnama Pa-c NPPES

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

PAULINA PURNAMA PA-C (NPI 1275724981) is an individual surgical provider in Fort Worth, Texas, licensed in Texas (PA11021) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Fort Worth, and maintains a secondary practice location in Keller.

NPPES Registry Identity

NPI1275724981
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NamePAULINA PURNAMACredential: PA-C
Location Address800 12TH AVE STE 200Fort Worth, TX 76104-2519
Mailing Address800 12th Ave Ste 200Fort Worth, TX 76104-2519 · (214) 631-9881 · Fax (469) 482-2526
Phone(214) 631-9881
Fax(469) 482-2526
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateAugust 7, 2007
Last NPPES UpdateMay 3, 20253 updates tracked since enumeration
NPPES CertifiedMay 3, 2025
✔ NPI 1275724981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in TX · PA11021
800 12TH AVE STE 200, Fort Worth, TX 76104
Open in Google Maps ↗

Secondary Practice Location 1

Location 11149 Keller Pkwy Ste AKeller, TX 76248-1620 · Phone (214) 631-9881 · Fax (469) 482-2526

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Paulina Purnama Pa-c 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 ID8325137060
PECOS Enrollment IDI20170509000883
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

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.

Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement 27236
This procedure involves treating a fracture at the top of your thigh bone. A stabilizing device or prosthetic replacement is placed to aid in healing. This helps restore mobility and function while reducing pain. The treatment aims for a quick and safe recovery.
11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450135
Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

Baylor Medical Center At Trophy Club

Acute Care Hospitals · Trophy Club, TX
OwnershipProprietary
CMS Certification Number450883
Location2850 E State Highway 114Trophy Club, TX 76262 · Denton County
Emergency services

Texas Health Harris Methodist Hospital Alliance

Acute Care Hospitals · Fort Worth, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670085
Location10864 Texas Health TrailFort Worth, TX 76244 · Tarrant County
Emergency services Birthing friendly

Methodist Southlake Medical Center

Acute Care Hospitals · Southlake, TX
OwnershipProprietary
CMS Certification Number670132
Location421 E State Highway 114Southlake, TX 76092 · Tarrant County
Emergency services

Other Providers at the Same Location NPPES 4

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

ALLEN S. KENT, MD, PA
Orthopaedic Surgery
800 12TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (817) 332-5591
DR. BANTOO SEHGAL M.D.
Orthopaedic Surgery (Sports Medicine)
800 12TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (214) 631-9881
SOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC
Orthopaedic Surgery
800 12TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (214) 631-9881
PRECISION ORTHOPEDICS & SPORTS MEDICINE
Durable Medical Equipment & Medical Supplies
800 12TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (972) 438-4636

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 Paulina Purnama's NPI number?

The NPI number for Paulina Purnama is 1275724981. It was assigned to this individual provider in the NPPES registry on August 7, 2007.

Where is Paulina Purnama located?

Paulina Purnama practices at 800 12th Ave Ste 200, Fort Worth, TX 76104. The listed phone number is (214) 631-9881.

What is Paulina Purnama's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Paulina Purnama enrolled in Medicare?

Yes. Paulina Purnama 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 Paulina Purnama accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 6 other insurers list Paulina Purnama 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.

Is Paulina Purnama affiliated with any hospitals?

According to CMS data, Paulina Purnama is affiliated with Texas Health Harris Methodist Hospital Fort Worth, Baylor Medical Center At Trophy Club, Texas Health Harris Methodist Hospital Alliance and Methodist Southlake Medical Center.

When was this NPI record last updated?

The NPPES record for Paulina Purnama was last updated on May 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.