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SURGICALIST OF TX PLLC
NPI 1972048510
Surgery in Fort Worth, TX

Active since January 05, 2017
909 9TH AVE STE 205, FORT WORTH, TX 76104(972) 665-6501(972) 866-4013 Get Directions Write a Review

NPPES record last updated: November 28, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 28, 2022, Apr 10, 2020, Oct 3, 2019 and 1 more (4 updates tracked since 2017).

About Surgicalist Of Tx Pllc NPPES

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

SURGICALIST OF TX PLLC (NPI 1972048510) is a healthcare organization registered as a surgery in Fort Worth, Texas and active in the NPI registry since January 2017. The organization lists Mit Desai, Ceo, as its authorized official.

NPPES Registry Identity

NPI1972048510
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameSURGICALIST OF TX PLLC
Location Address909 9TH AVE STE 205Fort Worth, TX 76104-3916
Mailing AddressPo Box 21647Tampa, FL 33622-1647 · (813) 530-5043 · Fax (813) 866-1957
Phone(972) 665-6501
Fax(972) 866-4013
Organization SubpartNo
Authorized OfficialMit DesaiCeo · (813) 530-5043
Enumeration DateJanuary 5, 2017
Last NPPES UpdateNovember 28, 20224 updates tracked since enumeration
NPPES CertifiedNovember 28, 2022
✔ NPI 1972048510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
909 9TH AVE STE 205, Fort Worth, TX 76104
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Surgicalist Of Tx Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Surgicalist Of Tx PLLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (5)

James Carroll, M.D.
General Surgery
NPI 1023048436
5236 W UNIVERSITY DR STE 2900
Mckinney, TX 75071
(469) 617-6550
✔ PECOS✔ Accepts Medicare51 mi
Malek Kanama
General Surgery
NPI 1023291705
18955 N MEMORIAL DR STE 430
Humble, TX 77338
(281) 378-3355
✔ PECOS✔ Accepts Medicare225 mi
David Gochnour
General Surgery
NPI 1609286913
6431 FANNIN ST MSB 4.162
Houston, TX 77030
(713) 500-7277
✔ PECOS✔ Accepts Medicare238 mi
Terah Isaacson, M.D.
Colorectal Surgery (Proctology)
NPI 1023220316
145 W 4TH ST STE 102
Cookeville, TN 38501
(931) 783-5515
✔ PECOS✔ Accepts Medicare716 mi
Nicholas Nunnally, D.O.
General Surgery
NPI 1043436462
1375 N MAIN ST
Lapeer, MI 48446
(810) 667-5590
✔ PECOS✔ Accepts Medicare1,044 mi

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 Surgicalist Of Tx PLLC's NPI number?

The NPI number for Surgicalist Of Tx PLLC is 1972048510. It was assigned to this organization in the NPPES registry on January 5, 2017.

Where is Surgicalist Of Tx PLLC located?

Surgicalist Of Tx PLLC is located at 909 9th Ave Ste 205, Fort Worth, TX 76104. The listed phone number is (972) 665-6501.

What is Surgicalist Of Tx PLLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Surgicalist Of Tx PLLC enrolled in Medicare?

Yes. Surgicalist Of Tx PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Surgicalist Of Tx PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Surgicalist Of Tx PLLC. 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 General Surgery (4) and Colorectal Surgery (Proctology) (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Surgicalist Of Tx PLLC was last updated on November 28, 2022. 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.