JEREMIAH DANIEL PAVELKA MD
NPI 1902366370
Emergency Medicine in Fort Worth, TX
About Jeremiah Daniel Pavelka Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEREMIAH DANIEL PAVELKA MD (NPI 1902366370) is an individual emergency medicine provider in Fort Worth, Texas, licensed in Arizona (69466) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mesa, and is a graduate of University Of Nevada School Of Medicine (2019).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
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
Jeremiah Daniel Pavelka Md 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.
Medicare Billing Reassignments
4Medicare enrollment records show Jeremiah Pavelka reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- 328 clinicians in this Medicare group
Chandler, AZ 85286
- Reassigned Medicare billing, Arizona enrollment
- 174 clinicians in this Medicare group
Mesa, AZ 85202
- Reassigned Medicare billing, Arizona enrollment
- 211 clinicians in this Medicare group
Chandler, AZ 85224
- Reassigned Medicare billing, Arizona enrollment
- 101 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 4
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.
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.
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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76104
FORT WORTH, TX 76104
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 Jeremiah Pavelka's NPI number?
The NPI number for Jeremiah Pavelka is 1902366370. It was assigned to this individual provider in the NPPES registry on March 22, 2019.
Where is Jeremiah Pavelka located?
Jeremiah Pavelka practices at 1500 S Main St, Fort Worth, TX 76104. The listed phone number is (817) 702-8840.
What is Jeremiah Pavelka's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Jeremiah Pavelka enrolled in Medicare?
Yes. Jeremiah Pavelka 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 organizations bill Medicare for Jeremiah Pavelka's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeremiah Pavelka reassigns Medicare benefits to 4 organizations: Integrative Emergency Services Physician Group PA (Fort Worth, TX), Cep America- Arizona, PC (Chandler, AZ), Progressive Medical Associates PLLC (Mesa, AZ) and Chandler Emergency Medical Group, LLC (Chandler, AZ). Each 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 Jeremiah Pavelka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jeremiah Pavelka accept?
Health plans from Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Jeremiah Pavelka 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 Jeremiah Pavelka was last updated on August 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jeremiah Daniel Pavelka, MD · NPI 1902366370
Emergency Medicine physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since March 22, 2019.
## Identity
- **NPI:** 1902366370 (Entity type: Individual)
- **Enumerated:** March 22, 2019
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 69466 (Arizona)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1500 S MAIN ST, Fort Worth, TX 76104-4917
- **Phone:** (817) 702-8840
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Integrative Emergency Services Physician Group PA (NPI 1285922542, Fort Worth, TX); Cep America- Arizona, PC (NPI 1780202804, Chandler, AZ); Progressive Medical Associates PLLC (NPI 1548218613, Mesa, AZ); Chandler Emergency Medical Group, LLC (NPI 1104871961, Chandler, AZ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Nevada School Of Medicine, class of 2019
## Record status
- **NPPES last updated:** August 5, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1902366370) · Data from the CMS NPPES public registry.