DEBORAH MOBOMBO PA-C
NPI 1649163494
Physician Assistant in Fort Worth, TX

Q: What is Deborah Mobombo's NPI number?

The NPI number for Deborah Mobombo is 1649163494. It was assigned to this individual provider in the NPPES registry on May 30, 2025.

Q: What is Deborah Mobombo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Deborah Mobombo was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since May 30, 2025PECOS EnrolledAccepts Medicare Assignment

1500 S MAIN ST FL 2, FORT WORTH, TX 76104(817) 702-3636(817) 927-8769 Get Directions Write a Review

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

Record update history: Jun 3, 2025, May 30, 2025 (2 updates tracked since 2025).

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About Deborah Mobombo Pa-c NPPES

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

DEBORAH MOBOMBO PA-C (NPI 1649163494) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (PA19125) and active in the NPI registry since May 2025. The provider is enrolled in Medicare PECOS, is affiliated with Jps Health Network, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1649163494

Entity TypeIndividual

Primary Taxonomy363A00000X

Provider Legal NameDEBORAH MOBOMBOCredential: PA-C

Location Address1500 S MAIN ST FL 2Fort Worth, TX 76104-4917

Mailing Address200 W Magnolia Ave Ste 201Fort Worth, TX 76104-7657 · (817) 702-2977 · Fax (817) 702-2140

Phone(817) 702-3636

Fax(817) 927-8769

Sole ProprietorNo

Medical School CMSDrexel University College Of MedicineGraduated 2024

Enumeration DateMay 30, 2025

Last NPPES UpdateJune 3, 20252 updates tracked since enumeration

NPPES CertifiedJune 3, 2025

✔ NPI 1649163494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TX · PA19125

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1500 S MAIN ST FL 2, Fort Worth, TX 76104

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Secondary Practice Location 1

Location 160 N 36th StPhiladelphia, PA 19104-5639 · Phone (215) 895-2000

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

Deborah Mobombo 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 ID8729599816

PECOS Enrollment IDI20250616002695

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.

Hospital Affiliations CMS Care Compare

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

Jps Health Network

Acute Care Hospitals · Fort Worth, TX

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450039

Location1500 S Main StFort Worth, TX 76104 · Tarrant County

Emergency services Birthing friendly

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

$70.45 typical visit price

range $18.18 – $139.68

Typical copayment $17.61 (range $4.54 – $34.92)

Most-billed visit code 99213

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 18

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

RYAN KOSTKA D.O.

Surgery (Surgical Critical Care)