NIDISH JOSE (AGNP-C) – Adult Health Nurse Practitioner, NPI 1104348903

NIDISH JOSE (AGNP-C) is a healthcare provider. based in Fort worth, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP-C. They hold a License No. 789098 (TX). The NPI Number for NIDISH JOSE (AGNP-C) is 1104348903

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
NIDISH JOSE (AGNP-C)
NPI
1104348903
Phone
(469) 844-7072
Address
3044 HIDDEN VALLEY DR
Enumeration Date
13 July 2017
Last Update Date
30 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2145921854
Graduation Year
2016 (10 years ago)
PAC ID
6507125713
Group Practice PAC ID
0547595852
Professional Enrollment ID
I20180117000013
Address ID
TX75006XXXXCAXXXXXXXXXX00
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for NIDISH JOSE (AGNP-C)

  • 3044 HIDDEN VALLEY DR

    FORT WORTH, TX 761772716

    Phone: (469) 844-7072

    Fax: (817) 697-4580

    Type: Location

  • 2700 Tibbets Dr Ste 300

    Bedford, TX 760225938

    Phone: (817) 484-0233

    Type: Location

  • Tibbets Drive, Bedford, Tarrant County, Texas, 76022-5841, United States

    BEDFORD, TX 760225938

    Phone: (817) 484-0233

    Type: Location

  • 3044, Hidden Valley Drive, Fort Worth, Tarrant County, Texas, 76177, United States

    FORT WORTH, TX 761772716

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $595.

Total Amount is formed as General ($595) + Research ($0) + Ownership ($0) = $595.

Last reported payment date: 2024-03-28 • Largest payer in this snapshot: ABBVIE INC. ($213).

Total Amount

$595

General + Research + Ownership

Payments

6

Total payment records

General Amount

$595

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-28

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-01-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180117000013INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes13575$0
99344Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes113113$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes6242$0
99347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes5640$0
G0181Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow5335$0
View full utilization report →

Insurance plans in this area (ZIP 76177)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547595852View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What number should I use to identify NIDISH JOSE (AGNP-C) for billing?
Administrative and clinical systems typically use NPI 1104348903 for NIDISH JOSE (AGNP-C).
Should I treat NIDISH JOSE (AGNP-C) as an active provider?
Patients and plans typically see NIDISH JOSE (AGNP-C) as active in the national extract.
Which specialty label fits NIDISH JOSE (AGNP-C)?
NPPES ties NIDISH JOSE (AGNP-C) to Adult Health Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit NIDISH JOSE (AGNP-C) in Fort Worth, Texas?
For routing, start with Fort Worth, Texas for NIDISH JOSE (AGNP-C), then verify phone and hours locally.
Can I export NIDISH JOSE (AGNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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