ID PARTNERS PA – Infectious Disease Physician, NPI 1174075857
Infectious Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ID PARTNERS PA
515 W Mayfield Rd Ste 404
Arlington, TX 760142085
Phone: (817) 539-9091
Fax: (817) 539-9553
Type: Location
816, Brighton Avenue, Shady Oaks, Southlake, Tarrant County, Texas, 76092, United States
SOUTHLAKE, TX 760926194
Phone: (817) 539-9091
Fax: (817) 539-9553
Type: Mailing
309, Regency Parkway, Walnut Landing, Mansfield, Tarrant County, Texas, 76063, United States
STE 205
MANSFIELD, TX 760635165
Phone: (817) 539-9091
Fax: (817) 539-9553
Type: Location
309 REGENCY PKWY STE 205
MANSFIELD, TX 760637305
Phone: (817) 539-9091
Fax: (817) 539-9553
Type: Mailing
350 MATLOCK RD STE 201
MANSFIELD, TX 76063
Phone: (817) 539-9091
Fax: (817) 539-9553
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2017-02-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (950 days ago).
Enrollment records
1
Earliest due date
2023-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170215002356 | O | Clinic/Group Practice | TX | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76014)
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