Longevity Bariatric and Wellness – Nephrology Physician, NPI 1295736973
Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Longevity Bariatric and Wellness
3025 N Tarrant Pkwy # 170
Fort Worth, TX 761778620
Phone: (817) 482-9831
Type: Location
1307 8th Ave Ste 403
Fort Worth, TX 761044143
Phone: (682) 207-1375
Type: Location
1000, West Cannon Street, Fort Worth, Tarrant County, Texas, 76104, United States
FORT WORTH, TX 761043029
Phone: (817) 877-5858
Fax: (817) 335-4418
Type: Location
1650 W Rosedale St Ste 302
Fort Worth, TX 761047400
Phone: (817) 885-7888
Type: Location
1650 W Rosedale St Ste 301
Fort Worth, TX 761047400
Phone: (817) 259-4333
Type: Location
1001 Pennsylvania Ave
Fort Worth, TX 761042228
Phone: (817) 877-5858
Type: Location
265 SE John Jones Dr Ste 102
Burleson, TX 760288356
Phone: (682) 990-0747
Type: Location
3101 Churchill Dr Ste 115
Flower Mound, TX 750222717
Phone: (469) 645-1804
Type: Location
6455 Hilltop Dr Ste 112
North Richland Hills, TX 761806039
Phone: (817) 482-9837
Type: Location
909 9th Ave Ste 202
Fort Worth, TX 761043916
Phone: (817) 877-4105
Type: Location
500 Lipscomb St
Fort Worth, TX 761042200
Phone: (817) 877-5858
Type: Location
6000 Colleyville Blvd Ste 150
Colleyville, TX 760348024
Phone: (817) 618-9997
Type: Location
5729 Bryant Irvin Rd
Fort Worth, TX 761324024
Phone: (817) 482-9832
Type: Location
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: 2004-07-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040702000316 | O | Clinic/Group Practice | TX | TBD |
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.
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 76177)
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