Fort Worth Lung Clinic, PA
NPI 1558655274 · Primary Care Clinic/Center · Burleson, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Fort Worth Lung Clinic, PA is a Primary Care Clinic/Center organization in Burleson, TX (NPI 1558655274).
Provider details
- NPI number
- 1558655274
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Dereje Ayo, President(817) 739-1080
- License
- N0617 (TX)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 800 8th Ave Ste 412Fort Worth, TX 76104-2618Phone: (817) 336-8773Fax: (817) 338-1063
Registry dates
- Enumerated
- 2011-05-31
- Last updated
- 2025-02-19
- Certified
- 2025-02-19
Frequently asked questions
- What is Fort Worth Lung Clinic, PA's NPI number?
- Fort Worth Lung Clinic, PA's National Provider Identifier (NPI) is 1558655274, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fort Worth Lung Clinic, PA?
- Fort Worth Lung Clinic, PA is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Fort Worth Lung Clinic, PA located?
- Fort Worth Lung Clinic, PA's practice location on file with NPPES is 11803 South Fwy Ste 136, Burleson, TX 76028-8460.
- What is Fort Worth Lung Clinic, PA's phone number?
- The practice phone number listed in the NPPES registry for Fort Worth Lung Clinic, PA is (817) 568-8411.
- Does Fort Worth Lung Clinic, PA accept Medicare?
- Fort Worth Lung Clinic, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Fort Worth Lung Clinic, PA?
- The authorized official listed on Fort Worth Lung Clinic, PA's NPPES record is Dereje Ayo, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fort Worth Lung Clinic, PA's NPI active?
- Yes — Fort Worth Lung Clinic, PA's NPI (1558655274) is active in the NPPES registry as of the last update on 2025-02-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.