FORT WORTH LUNG CLINIC, PA
NPI 1558655274
Clinic/Center - Primary Care in Burleson, TX
About Fort Worth Lung Clinic, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FORT WORTH LUNG CLINIC, PA (NPI 1558655274) is a healthcare organization registered as a primary care in Burleson, Texas and active in the NPI registry since May 2011. The organization maintains a secondary practice location in Fort Worth and lists Dereje Sahel Ayo, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fort Worth Lung Clinic, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Fort Worth Lung Clinic, PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Fort Worth Lung Clinic, PA's NPI number?
The NPI number for Fort Worth Lung Clinic, PA is 1558655274. It was assigned to this organization in the NPPES registry on May 31, 2011.
Where is Fort Worth Lung Clinic, PA located?
Fort Worth Lung Clinic, PA is located at 11803 South Fwy Ste 136, Burleson, TX 76028. The listed phone number is (817) 568-8411.
What is Fort Worth Lung Clinic, PA's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Fort Worth Lung Clinic, PA enrolled in Medicare?
Yes. Fort Worth Lung Clinic, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fort Worth Lung Clinic, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Fort Worth Lung Clinic, PA. A 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 the clinician's services. The largest specialties are Nurse Practitioner (8) and Pulmonary Disease (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Fort Worth Lung Clinic, PA accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 3 other insurers list Fort Worth Lung Clinic, PA 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 Fort Worth Lung Clinic, PA was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Fort Worth Lung Clinic, Pa · NPI 1558655274
Primary Care organization in Burleson, Texas. Organization record, active in the CMS NPPES registry since May 31, 2011.
## Identity
- **NPI:** 1558655274 (Entity type: Organization)
- **Enumerated:** May 31, 2011
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Dereje Ayo, PRESIDENT
## Practice location
- **Address:** 11803 SOUTH FWY STE 136, Burleson, TX 76028-8460
- **Phone:** (817) 568-8411 · **Fax:** (817) 568-8414
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Pulmonary Disease (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 19, 2025
- **Other identifiers:** Other N0617 (TX)
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Source: [NPI Profile](https://npiprofile.com/npi/1558655274) · Data from the CMS NPPES public registry.