MONIKA BUDHATHOKI FNP
NPI 1588038889
Nurse Practitioner - Family in Fort Worth, TX

Active since November 24, 2015PECOS EnrolledAccepts Medicare Assignment
79.87/100
CMS Quality Rating
900 W MAGNOLIA AVE STE 100, FORT WORTH, TX 76104(817) 870-7300(817) 533-4704 Get Directions Write a Review

NPPES record last updated: February 12, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 12, 2025, Feb 1, 2022, Jul 5, 2018 and 2 more (5 updates tracked since 2015).

About Monika Budhathoki Fnp NPPES

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

MONIKA BUDHATHOKI FNP (NPI 1588038889) is an individual family provider in Fort Worth, Texas, licensed in Texas (AP135189) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1588038889
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMONIKA BUDHATHOKICredential: FNP
Location Address900 W MAGNOLIA AVE STE 100Fort Worth, TX 76104-8518
Mailing AddressPo Box 35629Dallas, TX 75235-0629 · (817) 870-7300 · Fax (817) 533-4704
Fax(817) 533-4704
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateNovember 24, 2015
Last NPPES UpdateFebruary 12, 20255 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2025
✔ NPI 1588038889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · AP135189
900 W MAGNOLIA AVE STE 100, Fort Worth, TX 76104

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Monika Budhathoki Fnp 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 ID1153620679
PECOS Enrollment IDI20180806002710
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 Monika Budhathoki reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical Medical Laboratory
1800 PLAZA DR
Bedford, TX 76021
  • Reassigned Medicare billing, Texas enrollment
  • 575 clinicians in this Medicare group

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

Areas of Expertise CMS Part B claims 5

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
247 services201 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
236 services236 patients
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.
113 services102 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
31 services31 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
15 services15 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
$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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.55
Promoting Interoperability100
Improvement Activities40
Cost64.36

Other Providers at the Same Location NPPES 7

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

Internal Medicine (Gastroenterology)
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Nurse Practitioner
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Internal Medicine (Gastroenterology)
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Internal Medicine (Gastroenterology)
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Nurse Practitioner (Acute Care)
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Internal Medicine (Gastroenterology)
900 W MAGNOLIA AVE STE 100
FORT WORTH, TX 76104
Physician Assistant
900 W MAGNOLIA AVE STE 100
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 Monika Budhathoki's NPI number?

The NPI number for Monika Budhathoki is 1588038889. It was assigned to this individual provider in the NPPES registry on November 24, 2015.

Where is Monika Budhathoki located?

Monika Budhathoki practices at 900 W Magnolia Ave Ste 100, Fort Worth, TX 76104. The listed phone number is (817) 870-7300.

What is Monika Budhathoki's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Monika Budhathoki enrolled in Medicare?

Yes. Monika Budhathoki 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.

Which organization bills Medicare for Monika Budhathoki's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Monika Budhathoki reassigns Medicare benefits to Texas Digestive Disease Consultants, PLLC (Bedford, 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 Monika Budhathoki's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Monika Budhathoki 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 2 other insurers list Monika Budhathoki 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 Monika Budhathoki was last updated on February 12, 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.