Clara Formusoh, NP - Medicare Nurse Practitioner in Fort Worth, TX

Clara Formusoh, NP is a medicare enrolled "Nurse Practitioner - Family" in Fort Worth, Texas. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Texas Health Physicians Group and her current practice location is 1300 W Terrell Ave Ste K230, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 250-4906.

Clara Formusoh is licensed to practice in Texas (license number AP127181) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1023406576.

Contact Information

Clara Formusoh, NP
1300 W Terrell Ave Ste K230,
Fort Worth, TX 76104-2820
(817) 250-4906
(817) 250-1815

Map and Direction




Provider's Profile

Full NameClara Formusoh
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location1300 W Terrell Ave Ste K230, Fort Worth, Texas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Clara Formusoh graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1023406576
  • Provider Enumeration Date: 01/07/2015
  • Last Update Date: 02/17/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 0840516563
  • Enrollment ID: I20150224000431

Medical Identifiers

Medical identifiers for Clara Formusoh such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023406576NPI-NPPES
343075301MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family AP127181 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Texas Health Harris Methodist Hospital Fort WorthFort worth, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Texas Health Physicians Group43855359541182

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Clara Formusoh allows following entities to bill medicare on her behalf.
Entity NameTexas Health Physicians Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174573596
PECOS PAC ID: 4385535954
Enrollment ID: O20040323000759
Entity NameHolistic Health And Psychiatry
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649870783
PECOS PAC ID: 5890105829
Enrollment ID: O20201103002327
Entity NameTexas Health Virtual Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942951199
PECOS PAC ID: 5991176356
Enrollment ID: O20230121000123

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Clara Formusoh is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Clara Formusoh, NP
1300 W Terrell Ave Ste K230,
Fort Worth, TX 76104-2820

Ph: (817) 250-4906
Clara Formusoh, NP
1300 W Terrell Ave Ste K230,
Fort Worth, TX 76104-2820

Ph: (817) 250-4906

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.