Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Paulina Purnama, PA-C

Individual provider Surgical Physician Assistant · NPI 1275724981

Paulina Purnama, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2007, 19 years ago. Practices with Southlake Orthopedics and Sports Medicine PLLC, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
19
Licensed in
TX
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

800 12th Ave Ste 200
Fort Worth, TX 76104-2519
Phone: (214) 631-9881
Fax: (469) 482-2526
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1149 Keller Pkwy Ste A, Keller, TX 76248-1620 — (214) 631-9881

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA11021 (TX)

Record details

NPI number1275724981
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 7, 2007
Last updated in NPPESMay 3, 2025
Certification dateMay 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Southlake Orthopedics And Sports Medicine Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients36
Services billed 85 a service is one billed item, such as a visit, a test or a procedure
Average patient age79

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Travel and Lodging $909 2 payments · travel or lodging paid or reimbursed, such as to attend a conference
Food and Beverage $528 14 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Southlake Orthopedics and Sports Medicine PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice.

Other providers in Fort Worth