Paulina Purnama, PA-C - Medicare Physician Assistant in Fort Worth, TX

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Paulina Purnama, PA-C is a medicare enrolled "Physician Assistant - Surgical" in Fort Worth, Texas. She graduated from nursing school in 2007 and has 19 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Southlake Orthopedics And Sports Medicine Pllc and her current practice location is 800 12th Ave Ste 200, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (214) 631-9881.

Paulina Purnama is licensed to practice in Texas (license number PA11021) 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 1275724981.

Contact Information

Paulina Purnama, PA-C
800 12th Ave Ste 200,
Fort Worth, TX 76104-2519
(214) 631-9881
(469) 482-2526

Map and Direction




Provider's Profile

Full NamePaulina Purnama
GenderFemale
SpecialityPhysician Assistant
Experience19 Years
Location800 12th Ave Ste 200, 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:
  • Paulina Purnama graduated from nursing school in 2007
  NPI Data:
  • NPI Number: 1275724981
  • Provider Enumeration Date: 08/07/2007
  • Last Update Date: 05/03/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8325137060
  • Enrollment ID: I20170509000883

Medical Identifiers

Medical identifiers for Paulina Purnama such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275724981NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical PA11021 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Adaptive Home HealthTemple, TXHome health agency
Texas Health Harris Methodist Fort WorthFort worth, TXHospital
Baylor Medical Center At Trophy ClubTrophy club, TXHospital
Texas Health Harris Methodist Hospital AllianceFort worth, TXHospital
Methodist Southlake Medical CenterSouthlake, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southlake Orthopedics And Sports Medicine Pllc84263131312

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. Paulina Purnama allows following entities to bill medicare on her behalf.
Entity NameHealthtexas Provider Network
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760488936
PECOS PAC ID: 1355254210
Enrollment ID: O20040727001187
Entity NamePrecision Orthopedics & Sports Medicine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538257621
PECOS PAC ID: 4183672652
Enrollment ID: O20050111000785
Entity NameDoctx3 PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467808618
PECOS PAC ID: 1355620055
Enrollment ID: O20161121002559
Entity NameSouthlake Orthopedics & Sports Medicine PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871099739
PECOS PAC ID: 8426313131
Enrollment ID: O20180530002510

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. Paulina Purnama 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
Paulina Purnama, PA-C
800 12th Ave Ste 200,
Fort Worth, TX 76104-2519

Ph: (214) 631-9881		Paulina Purnama, PA-C
800 12th Ave Ste 200,
Fort Worth, TX 76104-2519

Ph: (214) 631-9881

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.