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VANDANA MALL AGNP
NPI 1306344791
Nurse Practitioner in Fort Worth, TX

Active since January 31, 2018PECOS Enrolled
1307 8TH AVE STE 506, FORT WORTH, TX 76104(817) 332-6092(817) 332-6015 Get Directions Write a Review

NPPES record last updated: January 31, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Vandana Mall Agnp NPPES

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

VANDANA MALL AGNP (NPI 1306344791) is an individual nurse practitioner in Fort Worth, Texas, licensed in Texas (802472) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306344791
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameVANDANA MALLCredential: AGNP
Location Address1307 8TH AVE STE 506Fort Worth, TX 76104-4142
Mailing AddressP.o. Box 961205Fort Worth, TX 76161-1205 · (817) 740-8400
Phone(817) 332-6092
Fax(817) 332-6015
Sole ProprietorNo
Enumeration DateJanuary 31, 2018
✔ NPI 1306344791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in TX · 802472
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1307 8TH AVE STE 506, Fort Worth, TX 76104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vandana Mall Agnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Vandana Mall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fort Worth Interventional LLC
25 mi
Pain Medicine
933 HILLTOP DR
Weatherford, TX 76086
  • Reassigned Medicare billing, Texas enrollment
  • 3 clinicians in this Medicare group
NPI 1902569445 (817) 692-4089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 4

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

TIM PAUL RATINO M.D.
Pain Medicine (Interventional Pain Medicine)
1307 8TH AVE STE 506
FORT WORTH, TX 76104
Tarrant County (817) 332-6092
REBECCA C MARTIN PA
Physician Assistant
1307 8TH AVE STE 506
FORT WORTH, TX 76104
Tarrant County (817) 332-6092
M&E ANESTHESIA SERVICES PLLC
Nurse Anesthetist, Certified Registered
1307 8TH AVE STE 506
FORT WORTH, TX 76104
Tarrant County (817) 740-8450
JENNIFER GRACE ZIELKE CRNA
Nurse Anesthetist, Certified Registered
1307 8TH AVE STE 506
FORT WORTH, TX 76104
Tarrant County (817) 332-6092

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 Vandana Mall's NPI number?

The NPI number for Vandana Mall is 1306344791. It was assigned to this individual provider in the NPPES registry on January 31, 2018.

Where is Vandana Mall located?

Vandana Mall practices at 1307 8th Ave Ste 506, Fort Worth, TX 76104. The listed phone number is (817) 332-6092.

What is Vandana Mall's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Vandana Mall enrolled in Medicare?

Yes. Vandana Mall is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Vandana Mall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vandana Mall reassigns Medicare benefits to Fort Worth Interventional LLC (Weatherford, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vandana Mall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vandana Mall was last updated on January 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.