Caitlin C. Oetken · Caitlin Leigh Craig · Medical Physician Assistant

4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905

Overview

Caitlin C. Oetken is a Medical Physician Assistant practicing in Fort Worth, Texas. The National Provider Identifier (NPI) is #1912390253, which was assigned on March 11, 2015, and the registration record was last updated on September 16, 2025. The practitioner's main practice location is at 4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905; the contact telephone number is 8174317985. The primary taxonomy of Caitlin C. Oetken is Medical Physician Assistant (363AM0700X), with specialization in Medical. Caitlin C. Oetken is licensed to practice in the state of Texas (#PA12191).

Provider Information

NPI 1912390253
Entity Type Individual
Provider Name CAITLIN C. OETKEN
Other Name CAITLIN LEIGH CRAIG
(Former Name)
Gender Female
Credential PA-C
Practice Address 4601 Heritage Trace Pkwy
Fort Worth
TX 76244-8905
Practice Telephone 8174317985
Mailing Address 4601 Heritage Trace Pkwy
Fort Worth
TX 76244-8905
Mailing Telephone 8174317985
Certification Date 2025-09-16
Enumeration Date 2015-03-11
Last Update Date 2025-09-16
Is Sole Proprietor Y

Doctor and Clinician Information

PAC ID 4789902099
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name CAITLIN OETKEN
Primary Specialty PHYSICIAN ASSISTANT
Address 4601 Heritage Trace Pkwy
Fort Worth
TX 76244-8905

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363AM0700XPhysician AssistantMedicalPA12191TX

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
014517600FLMEDICAID
IC674ZFLMCROther
Y0R0QFLBCBSOther

Secondary Practice Locations

AddressTelephoneFax
1680 Fm 407, Ste. 120, Northlake, TX 76247620181743179858174317985
1801 N Bedell Ave, Del Rio, TX 788408307689200

Taxonomy Information

Primary Taxonomy

Code 363AM0700X
Taxonomy Medical Physician Assistant
Classification Physician Assistant
Specialization Medical
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: Definition to come...

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Location Information

Street Address 4601 HERITAGE TRACE PKWY
City FORT WORTH
State TX
Zip Code 76244-8905
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Abigayle Ryan Cross · Abigayle Ryan Neel 4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905Physician Assistant2021-10-07
Roberta Jane Burk · Roberta Desplinter 4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905Audiologist2021-02-09
Brandon Lee Christianson 4601 Heritage Trace Pkwy, Fort Worth, TX 76244Otolaryngology Physician2010-05-07
Elizabeth Walstrom Kehrwald 4601 Heritage Trace Pkwy, Keller, TX 76244Audiologist2009-10-16
Kristin Marie Schmidt · Kristin Marie Horan 4601 Heritage Trace Pkwy, Fort Worth, TX 76244Audiologist2015-10-29
Spencer Pevahouse 4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905Audiologist2023-05-22
Akhila James 4601 Heritage Trace Pkwy, Fort Worth, TX 76244-8905Audiologist-Hearing Aid Fitter2021-07-08

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Tiffaney Smith 12650 North Beach Street, Suite 114-902, Keller, TX 76244Professional Counselor2025-10-03
Athletico Ltd 4560 Heritage Trace Parkway, Ste. 200, Fort Worth, TX 76244Physical Therapist2021-03-03
Keller Desai Dental PLLC 9500 Ray White Road, Suite 105, Fort Worth, TX 76244General Practice Dentistry2023-05-01
Ali Waadallah Altitinchi 5310 N Tarrant Parkway, Suite 106, Fortworth, TX 76244Endodontist2022-10-11
Emma Guilstorf 9726 N Beach St, Keller, TX 76244Social Worker2025-12-10
Divya Nilesh Rana 4801 Golden Triangle Blvd, Suite 121, Fort Worth, TX 76244Family Nurse Practitioner2024-01-29
Margaret Mackenzie Wilson 5320 North Tarrant Parkway, St 250, Fort Worth, TX 76244Behavioral Analyst2021-08-06
Brennan Benson Dds 13000 Park Vista Blvd, Fort Worth, TX 76244Dental Clinic/Center2023-07-21
Grace Elizabeth Awbrey 4917 Golden Triangle Blvd., Suite #421, Fort Worth, TX 76244Behavior Technician2025-01-20
Bethany Michelle Waltman · Bethany Michelle White 10640 N Riverside Dr., Suite 200, Fort Worth, TX 76244Speech-Language Pathologist2020-07-21
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.