Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

John David Deetjen, PA-C

Individual provider Physician Assistant · NPI 1508556028

John David Deetjen, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2023, 3 years ago. Practices with Texas Pulmonary and Critical Care Consultants PA, a 56-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone: (817) 335-5288
Fax: (817) 338-0927
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1508556028
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 9, 2023
Last updated in NPPESMay 9, 2023
Certification dateMay 9, 2023
Mailing address6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Texas Pulmonary And Critical Care Consultants Pa — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Worth